Two Cases of Mandibular Fractures in Child Treated by Open Reduction and Internal Fixation with a Titanium plate

Ishibashi, Shinnosuke

Two Cases of Mandibular Fractures in Child Treated by Open Reduction and Internal Fixation with a Titanium plate

Shinnosuke Ishibashi DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Yoshiyuki Okamoto D.D.S.,Ph.D., Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Chika Koyama DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Yasuharu Yajima DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Ayaka Noda DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Kensuke Kawada DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Masahiro Enomoto DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Masayuki Miyamoto DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Akira Fujimoto DDS, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Yoshimi Ishikawa DDS, PhD, Department of Dentistry and Oral Surgery, Fujisawa City Hospital, Fujisawa, Japan

Abstract

In the treatment of mandibular fracture in child, avoiding any damage to uneruptal tooth bud, and growth and development of mandible bone are considered exceptionally.Therefore, reduction and fixation by splint and circumferential wiring is performed generally. However, in the case of displaced fracture, open reduction and internal fixation(ORIF) should be applied. On the other hand, the case of condylar fracture needs the jaw opening exercise early to prevent mandibular ankylosis. For that reason, in the case of condylar and mandibular body fracture, it is important to perform ORIF of mandibular body fracture as soon as possible. We report two cases of mandibular fracture (midline and bilateral condyle) in 3 years-old and 10 months boy and 1 years-old and 9 months girl. We planed the operation in reference to CT scans to avoid uneruptal tooth bud and ORIF of midline fracture with a titanium plate was performed. The titanium plate was removed after 6 month, for preventing growth and development of mandible bone. Postoperative causes have been uneventful.

Case

Case1: 3 years-old and 10 months boy fell from a height of 2 meters. ORIF of midline fracture with a titanium plate was performed on December 3rd, 201X.

Case2: 1 years-old and 9 months girl fell from bicycle driving by her mother. ORIF of midline fracture with a titanium plate was performed on September 29th, 201X.

As they did not need intermaxillary fixation, they could open the mouth and take ordinary diet at early stage of the post operation.

Conclusions

In the treatment of mandibular fracture in child, we made a plan of the plating position and the size of screw in reference to CT scans, and ORIF of mandibular fracture with a titanium plate was performed safety.

References

1. Robert H. Mathog,M.D. :MAXILLOFACIAL TRAUMA :Baltimore,MD:Williams&Wilkins:pp136-147

2. Myall R.W.:Management of mandibular fractures in children:Oral Maxillofac Surg Clin North Am 21:193-196:vi2009