The effect on facial growth of pediatric mandibular fractures

The incidence of facial fractures in the pediatric population is between 1.4% and 15% of all maxillofacial traumas. Forty-one percent of pediatric facial fractures involve the mandible. No study has commented on the incidence of mandibular fractures that go on to develop growth disturbances leading to asymmetry and malocclusion. A retrospective chart review was carried out that identified and followed 88 children who sustained mandibular fractures and presented to The Hospital for Sick Children in Toronto during the 13-year period from 1980 to 1993. Patient follow-up ranged from 2 to 15 years, and was performed via phone survey and medical/orthodontic chart review. Patients who required orthodontics and orthognathic surgery were identified. Results indicated that a pediatric mandibular fracture does not lead to a higher incidence of orthodontic intervention. Furthermore, children younger than 4 years or older than 12 years rarely require orthognathic surgery to correct facial growth disturbances following mandibular fractures. In contrast, 22% of children age 4 to 7 years, and 17% of children age 8 to 11 years required orthognathic surgery to correct facial growth disturbances following mandibular fractures. Condylar fractures were the most common site of mandibular fracture, and led to facial asymmetry most frequently.