• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.448-456
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• 2011

Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.477-482
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• 2003

The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complication such as TMJ ankylosis and reta rdation of mandibular development. Most pediatric condylar fracture is mainly performed by the conservative or functional treatment, but it may be required open reduction according to cases. In this study, activator is applied for functional treatment of pediatric condylar fracture and fair recovery of jaw function is acquired.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.453-458
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• 2004

Mandibular fracture is less common in children than in adults. However, children are more susceptible to ankylosis and developmental disorders, and don't respond as well to intermaxillary fixation compared to adults. On the other hand, bone fracture is healed more quickly in children and complications are scarce. Mandibular fracture in children is usually treated successfully with acrylic splint therapy with or without the use of eyelet wires and intermaxillary fixation. Severe complications that include ankylosis and developmental disorders may occur. The frequency and severity of such complications can be mitigated with a shorter duration of intermaxillary fixation and good post-operative care. Encouraging mandibular physical therapy by increasing patient motivation may be necessary in such cases where the patient's response is poor and the duration of intermaxillary fixation increases; when the patient is unable to undergo physical therapy, or when intermaxillary fixation is not necessary with the patient showing only minor symptoms such as trismus. In this case report, a 6 year-old girl with bilateral condylar fracture was treated with elastic in both the upper and lower jaws to allow mandibular physical therapy using a Benoist's appliance, which allows opening, lateral, and protrusive retrusive movements of the mandible. A 7-month follow-up showed beneficial therapeutic effects such as increased mandibular movement and prevention of condylar ankylosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.1-8
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• 2020

The aim of this retrospective study was to investigate etiology, clinical features, and treatment modalities of the mandibular condyle fracture in children and young adolescents. This study was conducted based on medical records and radiographic examinations of 44 pediatric patients. Patients received treatment under diagnosis of mandibular condylar fracture. They were divided into 4 groups according to their age. The involvement of condyle in the mandible fracture occurred in higher percentage in younger age groups. Falling was the most common etiologic factor in all age group, especially in children with age under 7. Condyle head was the most frequent site of fracture in age group of 4 - 7 whereas fracture tends to occur in lower condylar areas in older groups. In 54.5% of the mandibular condyle fracture, symphysis fracture was accompanied. Teeth injury occurred in higher incidency when condyle fracture accompanied symphysis fracture. Conservative treatments were applied to 43 out of 44 patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.378-385
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• 2018

Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.49-55
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• 2004

The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.221-224
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• 2009

Purpose: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications - mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. Materials: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular - maxillary fixations were removed after 3 weeks, and patients went into training for mouth opening. Results: The technique didn't result in complications - joint dysfunction, facial nerve injury, sore, infection and nonunion during follow - up period. Radiologic follow - up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. Conclusions: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.