One hundred cases of mandibular fractures in children in Iraq

Pediatric Facial Fractures: A 10-year Study

Aims and Objectives

The aim of the study is to retrospectively analyse the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries and any complications of paediatric patients operated in Craniofacial unit of SDM college of dental sciences and hospital.

Materials and Methods

This retrospective study was conducted at the department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003-December 2013. All the patients below 15 years of age were included in the study. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries and different treatment protocols.

Results

A total of 68 cases of paediatric fracture were treated during these 10 years. Boys were commonly injured than girls with a ratio of 2.9:1, the commonest cause of trauma was fall (59 %), mandible was the commonest bone to be fractured (83 %), treatment protocols were dependant on the age, region and type of fracture but in most of the cases closed reduction was the choice of treatment, dental injuries were seen in 26 % patients and the commonest injury was avulsion.

Conclusion

This study was done not only to analyse the different types of facial fractures and the pattern of fracture of paediatric cases admitted at this centre, but also to act as a contributional data which will help us to take preventive measures to avoid such injuries and make the appropriate treatment plan and execute it to achieve the pre-injury status of form and function.

Treatment of TMJ ankylosis in Jordanian children - a comparison of two surgical techniques

INTRODUCTION

The aim of this study was to report Jordanian experience in surgical treatment of TMJ ankylosis in 22 children.

PATIENTS AND METHODS

This retrospective clinical study included children who were diagnosed with TMJ ankylosis and were treated in a dental teaching centre between 1993 and 2001. Patients underwent the release of 24 temporomandibular joint ankyloses and two different surgical techniques were used: either reconstruction of the condyle using costochondral grafts, or using the temporalis muscle as an interpositional material. Patients were followed up for 1-8 years.

RESULTS

Twenty-two children (13 males and 9 females) were included in the study. Costochondral grafts were used as a reconstruction material in 16 TMJs (67%), whilst temporalis muscle was used as an interpositional material in 8 joints (33%). The mean preoperative maximum interincisor distance was 6.6 mm+/-1.3, which was increased to a mean of 30.3 mm+/-2.5 postoperatively. Two female patients (9%) suffered recurrence of the ankylosis within 6-12 months postoperatively. In one of these, a costochondral graft was used and temporalis muscle interposition in the other.

CONCLUSION

Costochondral graft as a reconstruction material and temporalis muscle as an interpositional material showed comparable success rates when treating TMJ ankylosis in 22 children.

Remodelling following condylar fractures in children

PURPOSE

In this study, 18 children with 21 subcondylar fractures sustained during their growth period (age at trauma from 4-11 years, mean 7.7 years) have been followed-up.

MATERIAL AND METHODS

All patients were treated by custom-made arch bars and intermaxillary fixation for 12-17 days, then kept on a liquid diet for 15 days without fixation. The mean follow-up was 4.7 years. The conservative treatment has been evaluated with clinical, radiographic, and functional parameters.

RESULTS

Remodelling of the condylar head was good in 17, whilst moderate remodelling occurred in the other four condyles. In four patients, a slight deflection (less than 2 mm) to the side of the fracture on wide mouth opening was seen. There was no malocclusion or ankylosis.

CONCLUSION

Conservative treatment of condylar fractures during growth resulted in good function and good remodelling of the condyle. Functional treatment after intermaxillary fixation for 12-17 days proved to be quite acceptable.

Fractures of the facial skeleton in children: a survey of patients under the age of 11 years

A clinico-statistical study was performed on 40 children aged less than 11 years of age, with maxillofacial fractures. Age, sex, type of fracture, incidence, aetiology, methods of treatment and complications were studied. The ratio of boys to girls was 2.6:1.0 and the highest incidence was at age 10 years. Mandibular fractures were the most common and the condylar region was particularly affected. Falls, road traffic accidents and sport injuries, including play accidents, were the major causes of these injuries. Conservative therapy, such as maxillo-mandibular fixation using eyelet wiring, was usually performed and was found to be successful. Ankylosis of the temporomandibular joint was seen in one patient. Infection was observed in three cases. One child had retarded facial growth due to damage to the condylar growth centre. Malunion and non-union were not seen. No deaths were recorded.

An epidemiological study of patterns of condylar fractures in children

OBJECTIVE

To find out how the site and type of condylar fracture are affected by its aetiology and the age and sex of the patient.

DESIGN

Retrospective study.

SETTING

Tertiary referral centre, Finland.

MATERIAL

Radiographs of 101 children (aged 15 years or less) with 119 condylar fractures.

MAIN OUTCOME MEASURES

Site of fracture and degree of displacement.

RESULTS

A total of 26 of the 119 fractures were intracapsular (22%) and 93 (78%) extracapsular. Only among patients less than 6 years of age was there a preponderance of intracapsular fractures (7/12 fractures in 10 patients, 58%). In the older children 78% (83/107) were in the condylar neck. There were few subcondylar fractures (5/119, 4%). Only 6 fractures were displaced (5%). Dislocation of the condyle from the glenoid fossa was common in all age groups.

CONCLUSION

The site of condylar fracture is age related, but not associated with sex or aetiology.

Maxillofacial injuries in a group of South Africans under 18 years of age

OBJECTIVE

To find out the incidence of maxillofacial injuries in South African children aged 18 years or less.

DESIGN

Retrospective study of casenotes.

SETTING

Six teaching hospitals affiliated to the University of Witwatersrand, Johannesburg, serving a population of about 5 million people.

SUBJECTS

All 326 children treated for facial injuries in the maxillofacial and oral departments of the six hospitals between 1 January 1989 and 30 June 1992.

MAIN OUTCOME MEASURES

Classification of the types of injury, associated injuries, cause of the injury, and methods of diagnosis.

RESULTS

Of the total of 4192 patients of all ages treated for facial injuries, 326 (8%) were within the age range of the study. The female:male ratio was 1:2.3. Most of the injuries (227, 70%) occurred in the 13-18 age group, and assaults, fights and gunshot wounds accounted for 155 injuries (48%). Of the 326 children, 173 (53%) had single injuries and 153 (47%) had multiple injuries. Mandibular fractures were the most common (64%) followed by maxillomandibular fractures (25%). Violence was the most common cause of injury, as in the USA and Zimbabwe, but unlike the rest of the world in which it is motor vehicle accidents. Soft tissue injuries were the most common associated injuries, and conventional plain radiography was the usual investigation.

CONCLUSION

The incidence of 8% compares favourably with those in other countries, but far too many injuries are the result of violence.

Fractures of the maxillofacial region in children

83 children with maxillofacial fractures have been analyzed according to, aetiology, age, sex, type, and site of fractures. The results showed a high male to female ratio. Mandibular fractures were the commonest, in the condylar region in particular. The commonest causes in descending order were falls, bicycle accidents and at play.

Fractures of the facial skeleton in children

Fractures of the facial skeleton are infrequent in children. A series of 147 fractures in 116 children aged from 10 days to 13 years old was retrospectively reviewed. The male to female ratio was 1.4:1 and the highest incidence occurred in the age group 8 to 10 years. The main aetiological factor was road traffic accidents. The mandible was predominantly involved (83.7%). The incidence of fractures of the middle third of the face was very low (4.0%). Closed reduction was undertaken most frequently. Complications were found to be minimal.

Incidence and aetiology of fractures of the facio-maxillary skeleton in Trivandrum: a retrospective study

A retrospective look at the incidence and aetiology of fractures of the facio-maxillary skeleton over a 2 year period was carried out in the department of Oral and Maxillofacial Surgery, Dental College, Trivandrum, India.