Open versus closed reduction: mandibular condylar fractures in children

Area of Science:

• Pediatric dentistry
• Oral and maxillofacial surgery
• Craniofacial trauma management

Background:

• Pediatric mandibular condylar fractures (MCFs) present unique challenges due to the growing craniofacial skeleton.
• Understanding the evolution of management strategies is essential for optimal patient care.

Purpose of the Study:

• To review the literature on the evolution of current management strategies for pediatric mandibular condylar fractures (MCFs).

Main Methods:

• A comprehensive electronic literature search was conducted in PubMed.
• Studies published in English or German from 1992 to 2012 concerning pediatric MCFs were included.
• Eligibility criteria focused on clinical series of patients up to 18 years of age.

Main Results:

• The search identified 29 relevant studies after initial screening and hand-searching.
• Conservative treatment (CTR) demonstrates satisfactory long-term outcomes for jaw function, occlusion, and facial aesthetics.
• Surgical intervention is typically reserved for specific complex cases or when conservative treatment fails.

Conclusions:

• Pediatric MCFs necessitate tailored management to avoid growth disturbances and ensure favorable development.
• Early treatment and vigilant long-term follow-up are vital for addressing potential late complications.
• Coronal CT aids in accurate diagnosis, while the indications for surgery increase with age due to decreased remodeling capacity.