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Management of Mandibular Condyle Fractures in Paediatric Patients: a Systematic Review
Ian Jenkyn1, Robert Bosley2, Claire Jenkyn3
1Oral and Maxillofacial Surgery Department, Addenbrookes Hospital, Cambridge, Hills Rd, Cambridge CB2 0QQUnited Kingdom.
Insights
Current evidence suggests no significant difference between surgical and non-surgical management for paediatric mandibular condyle fractures. Conservative treatment appears functionally adequate with low surgical risks.
Area of Science:
- Oral and Maxillofacial Surgery
- Pediatric Traumatology
Background:
- Mandibular condyle fractures are common in pediatric patients.
- Optimal management strategies require clear evidence-based guidelines.
Purpose of the Study:
- To systematically review and assess evidence comparing surgical versus non-surgical management of pediatric mandibular condyle fractures.
- To determine if significant differences exist in outcomes and complications between the two treatment modalities.
Main Methods:
- A systematic literature search was performed across Ovid, PubMed, and Web of Science databases.
- Studies published between January 1996 and April 2022, focusing on pediatric patients with mandibular condyle fractures, were included.
- Data from 20 selected studies were analyzed, with a focus on complications and outcomes, using Chi-Square tests.
Main Results:
- A total of 182 records were screened, with 20 studies meeting the inclusion criteria.
- The included studies exhibited a high risk of bias, limiting definitive conclusions.
- Pooled data analysis revealed no statistically significant difference in outcomes between surgical and non-surgical management approaches.
Conclusions:
- Current evidence indicates that conservative (non-surgical) management is functionally adequate for pediatric mandibular condyle fractures.
- The risks associated with surgical intervention appear low, but conservative management offers a viable alternative without these surgical risks.
Objectives:
This systematic review searched three of the most used databases to assess if current evidence suggested a difference between surgical and non-surgical management of mandibular condyle fractures in paediatric patients.
Material And Methods:
An electronic literature search was conducted of three well known databases - Ovid, PubMed and Web of Science. Studies included were conducted paediatric patients, in humans, written in English and published from January 1st 1996 until April 1st 2022. Data collection was carried out by two independent reviewers. Data collated from studies without high risk of bias was pooled for surgical vs non-surgical management and total tallies of all outcomes presented. Presence or absence of complications was recorded in 4 x 4 tables for each outcome and compared using a Chi-Square test.
Results:
After duplicate records were removed, 182 records were screened. After exclusion of unsuitable reports, 20 were included in the review. Further analysis showed the included studies had high risk of bias. Given this, comparison of this pooled data showed no significant difference between management methods.
Conclusions:
Presently it appears conservative management is functionally adequate without risks associated with surgical management, even though incidence of these risks was shown to be low in the studies included in this review.
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