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Updated: Jul 28, 2026
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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Pediatric mandibular fractures: a free hand technique
S P Davison1, M S Clifton, M N Davison
1Division of Plastic Surgery, Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, DC 20007, USA.
Archives of Facial Plastic Surgery
|August 11, 2001
Summary
Open reduction internal fixation without intermaxillary fixation (IMF) offers faster recovery for pediatric mandibular fractures. This technique reduces operative time and improves early return to function with fewer oral hygiene issues.
Area of Science:
- Pediatric surgery
- Oral and maxillofacial surgery
- Trauma surgery
Background:
- Pediatric mandibular fractures present unique challenges due to mixed dentition.
- Treatment approaches for these fractures are often debated.
- Current methods can lead to prolonged recovery and hygiene difficulties.
Purpose of the Study:
- To evaluate the efficacy of open mandibular fracture repair using rigid plate fixation without intermaxillary fixation (IMF).
- To assess the benefits of free-hand occlusal and bone reduction techniques.
- To discuss postoperative advantages, including early functional recovery and improved oral hygiene.
Main Methods:
- A study involving 29 pediatric patients with mandibular fractures was conducted.
- Twenty patients (mean age 9 years) underwent open reduction internal fixation without IMF.
- Surgical technique involved intraoral and extraoral rigid plate placement after free-hand reduction.
Main Results:
- Open reduction internal fixation without IMF reduced surgical time by approximately 1 hour compared to IMF.
- Patients treated without IMF resumed a soft diet significantly earlier (postoperative day 3 vs. day 16).
- Complication rates were comparable between groups (20% without IMF vs. 33% with IMF).
Conclusions:
- Free-hand reduction is an effective technique for pediatric mandibular fractures, reducing operative time.
- This method promotes a faster return to function and minimizes oral hygiene complications.
- It also reduces the need for hardware removal associated with intermaxillary fixation.
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