Paediatric Mandibular Fracture- An Enigma of its Own: A Case Report
Dr. Pulkit Khandelwal,
Associate Professor, Department of Oral and Maxillofcial Surgery, OPD No. 307, Rural Dental College, PIMS-DU, Loni, Ahmednagar-413736, Maharashtra, India.
Mandibular fractures are very rare in the paediatric age group; however, they remain the most common maxillofacial trauma occurring in children. A paediatric mandibular fracture can cause severe pain and discomfort for the patient. Due to the complex anatomy of the developing mandible, such as the presence of permanent tooth buds and its small size, the treatment of mandibular fractures in the paediatric age group differs markedly from that in adults. Treatment of maxillofacial fractures in the paediatric population has always been a challenge for the operating surgeon. Different treatment modalities for managing paediatric mandibular fractures include closed reduction or surgical intervention. Open/closed cap splint provides closed reduction and stabilisation of paediatric mandibular fractures without any risk of damage to permanent tooth buds. It is more commonly preferred over Open Reduction and Internal Fixation (ORIF) of the fractures. However, for highly displaced fractures, ORIF is the preferred treatment. In the present case report, the author present and describe the management of a mandibular symphyseal and medial pole of the right condyle fracture in a seven-year-old patient. Since the bone fragments were highly displaced and occlusion was severely deranged with an anterior open bite, conservative treatment using a cap splint was not considered. ORIF was performed under general anaesthesia. At the one-year follow-up, complete clinical and radiological bone healing was observed. Occlusion was satisfactory, and mouth opening was maintained. There was normal eruption of permanent teeth with no complications or delays associated with the eruption pattern.