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Keywords = pediatric mandibular condyle fractures

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11 pages, 1260 KiB  
Article
Conservative vs. Surgical Management of Condylar Fractures in Pediatric Populations: Complications and Factors for Consideration
by Chaim Ohayon, Amit Perelman, Adi Katz Biton, Andrei Krasovsky, Nidal Zeineh, Jiriys George Ginini, Adi Rachmiel, Amir Bilder and Omri Emodi
Children 2025, 12(3), 323; https://doi.org/10.3390/children12030323 - 3 Mar 2025
Viewed by 1159
Abstract
Background: The optimal treatment decision for pediatric condylar fractures is influenced by various factors, including the child’s age, fracture type, degree of displacement, and the presence of concomitant injuries. While non-surgical treatments are generally preferred due to high remodeling capacity in children, there [...] Read more.
Background: The optimal treatment decision for pediatric condylar fractures is influenced by various factors, including the child’s age, fracture type, degree of displacement, and the presence of concomitant injuries. While non-surgical treatments are generally preferred due to high remodeling capacity in children, there remains a lack of comprehensive research comparing the long-term outcomes of open reduction internal fixation (ORIF) versus conservative management. Methods: Retrospective analysis of medical records of 71 pediatric patients (aged 0–18 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery, Rambam Healthcare Campus, between 2010 and 2020 was completed. Gender, age, admission date, cause of injury, treatment methods, length of hospital stay, follow-up duration, and follow-up status were studied to help determine association with modality of treatment and complications. Results: No statistically significant differences were seen in complication rates across different age groups, genders, trauma etiologies, fracture sites (head/neck/base), laterality of fractures, nor was there an impact on choice of surgical vs. conservative intervention. Similar length of hospital stay was observed, even in cases with delayed surgical intervention. There was also no statistical significance of injury distribution based on socioeconomic standing. Conclusions: Our research showed similar rates of complications in both surgically treated and conservatively treated cases. This solidifies the importance of practitioner experience, as well as comprehensive anamnesis to help caretakers most effectively determine the optimal treatment for each patient. As the surgical study group is substantially smaller than the conservatively treated group, large-scale prospective studies with extended follow-up will more conclusively help solidify results and establish guidelines. Full article
(This article belongs to the Section Pediatric Surgery)
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22 pages, 370 KiB  
Review
Management of Pediatric Mandibular Condyle Fractures: A Literature Review
by Gian Battista Bottini, Fabio Roccia and Federica Sobrero
J. Clin. Med. 2024, 13(22), 6921; https://doi.org/10.3390/jcm13226921 - 17 Nov 2024
Cited by 2 | Viewed by 2148
Abstract
This narrative review evaluates the literature on the management of mandibular condyle fractures in growing patients. It aims to illustrate some fundamental biological principles and to offer a series of considerations applicable to clinical practice. The discussion is based on 116 papers published [...] Read more.
This narrative review evaluates the literature on the management of mandibular condyle fractures in growing patients. It aims to illustrate some fundamental biological principles and to offer a series of considerations applicable to clinical practice. The discussion is based on 116 papers published in PubMed and two relevant textbooks. Condylar fractures may be overlooked, especially in pre-scholar children, where compliance is usually reduced. However, these injuries can have disabling sequelae such as ankyloses, facial deformities, malocclusion, and chronic pain in some patients if not diagnosed and managed correctly. Due to their significance, mandibular condyle fractures in children are a subject of considerable clinical interest. As of today, there is consensus about their treatment. Four management options are available: expectative (analgesia, soft food and follow-up), functional protocols (guiding elastics, orthodontic appliances and exercises), maxillomandibular fixation (MMF), and open reduction and internal fixation (ORIF). Nondisplaced and minimally displaced fractures should be treated expectantly; severely displaced non-comminuted fractures can be safely operated on if the expertise is available, even in patients with deciduous dentition. Moderately displaced fractures can be managed with functional protocols or operatively, depending on the background and know-how of the specialist. Functional protocols can achieve good outcomes, especially in patients with deciduous dentition. MMF should be foregone in children due to its many drawbacks. Full article
(This article belongs to the Special Issue New Advances in Oral and Facial Surgery)
16 pages, 2674 KiB  
Article
Management of Mandibular Condyle Fractures in Pediatric Patients: A Multicentric Retrospective Study with 180 Children and Adolescents
by Gian Battista Bottini, Wolfgang Hitzl, Maximilian Götzinger, Constantinus Politis, Kathia Dubron, Mario Kordić, Anamaria Sivrić, Petia Pechalova, Angel Sapundzhiev, Valfrido Antonio Pereira-Filho, Luis Fernando de Oliveira Gorla, Emil Dediol, Boris Kos, Tabishur Rahman, Sajjad Abdur Rahman, Sahand Samieirad, Timothy Aladelusi, Vitomir S. Konstantinovic, Marko Lazić, Aleš Vesnaver, Anže Birk, Karpal Singh Sohal, Sean Laverick, Euan Rae, Maria Beatrice Rossi, Fabio Roccia and Federica Sobreroadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(18), 5455; https://doi.org/10.3390/jcm13185455 - 14 Sep 2024
Cited by 5 | Viewed by 2728
Abstract
Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study [...] Read more.
Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. Methods: A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. Results: 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment—stand-alone maxillomandibular fixation (MMF)—in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments (p < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. Conclusions: Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry. Full article
(This article belongs to the Special Issue New Advances in Oral and Facial Surgery)
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3 pages, 104 KiB  
Case Report
Unusual Superolateral Dislocation of Mandibular Condyle
by Tabishur Rahman
Craniomaxillofac. Trauma Reconstr. 2018, 11(2), 142-144; https://doi.org/10.1055/s-0037-1601433 - 3 Apr 2017
Cited by 4 | Viewed by 68
Abstract
We describe a case of maxillofacial trauma in a pediatric patient in whom the mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact. In addition, there was an associated mandibular symphyseal fracture. To our knowledge, [...] Read more.
We describe a case of maxillofacial trauma in a pediatric patient in whom the mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact. In addition, there was an associated mandibular symphyseal fracture. To our knowledge, this case is the first of its kind to be reported in the literature. We also observed a complication in the form of development of ankylosis in the involved joint which required another surgery. Full article
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3 pages, 161 KiB  
Case Report
Condylar Fracture in a Child with Entrapment of the Inferior Alveolar Nerve
by Constantinus Politis, Yi Sun, Jimoh Agbaje, Ivo Lambrichts, Maria Piagkou and Reinhilde Jacobs
Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 149-151; https://doi.org/10.1055/s-0035-1563391 - 18 Aug 2015
Abstract
The aim of this article is to report the clinical case of a right subcondylar fracture in a 4-year-old boy. The displaced and medial angulated fragmented mandibular condyle in coexistence with an enlarged lateral pterygoid process was compressing the inferior alveolar nerve (IAN) [...] Read more.
The aim of this article is to report the clinical case of a right subcondylar fracture in a 4-year-old boy. The displaced and medial angulated fragmented mandibular condyle in coexistence with an enlarged lateral pterygoid process was compressing the inferior alveolar nerve (IAN) during its course in the area of the infratemporal fossa. This was expressed by exhibiting a rubbing behavior with resulting superficial ulceration at the right lower lip. Hypoesthesia of the lower lip may be a sign of the IAN entrapment after a subcondylar fracture in a child. In contrast to the adults where an open reduction is necessary to relieve the symptoms of hypoesthesia, in pediatric population, a conservative approach seems sufficient. Full article
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