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Long-term Sequelae of Pediatric Maxillofacial Fractures
Xinnan Chang1, Maoye Li2, Kaixin Yan1
1State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan.
Insights
Pediatric maxillofacial fractures can lead to long-term issues like temporomandibular joint osteoarthritis and facial deformities. Early surgical intervention for specific fracture types is recommended to prevent these sequelae.
Area of Science:
- Pediatric surgery
- Oral and maxillofacial surgery
- Orthodontics
Background:
- Maxillofacial fractures in children can result in significant long-term complications.
- Understanding the causes of these sequelae is crucial for improving treatment outcomes.
Purpose of the Study:
- To investigate the long-term sequelae of pediatric maxillofacial fractures.
- To analyze the contributing factors to these long-term complications.
Main Methods:
- A case series study involving 25 pediatric patients with long-term sequelae after maxillofacial fractures.
- Analysis of preoperative, postoperative, and follow-up data.
Main Results:
- Common sequelae included temporomandibular joint osteoarthritis (48%), facial deformity (20%), and blindness (20%).
- Temporomandibular joint ankylosis (12%) was associated with concurrent mandibular body and condyle fractures treated conservatively.
- Facial deformities were linked to severely displaced fractures and inadequate reduction.
Conclusions:
- Surgical intervention is advised for pediatric maxillofacial fractures showing lateral ramus stump dislocation and reduced joint space on CT scans.
- Anatomic reduction during surgery is essential for severely displaced fractures to prevent facial deformities.
Abstract:
This study aimed to investigate the long-term sequelae of pediatric maxillofacial fractures and further analyze the causes of these sequelae. A case series study was conducted on children with long-term sequelae after maxillofacial fractures treated between January 2015 and December 2020 in our institution. Relevant preoperative, postoperative, and follow-up data were collected and analyzed. A total of 25 patients were included. The long-term sequelae of pediatric maxillofacial fractures included temporomandibular joint osteoarthritis (12/25), facial deformity (5/25), blindness (5/25), temporomandibular joint ankylosis (3/25), visual impairment (2/25), and permanent facial nerve injury (1/25). All cases of temporomandibular joint ankylosis involved concurrent fractures of the mandibular body and condyle, and all patients received conservative treatment. Preoperative CT scans showed lateral dislocation of the ramus stump and reduced joint space in all patients. All patients with facial deformities exhibited severely displaced fractures and had undergone inadequate fracture reductions. As a conclusion, surgical intervention should be considered for pediatric maxillofacial fractures when CT scans reveal lateral dislocation of the ramus stump and diminished joint space. For severely displaced pediatric maxillofacial fractures, anatomic reduction should be achieved during surgery to prevent facial deformities.
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