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Mandibular Fracture in a 3-Month-Old Infant: Conservative Management and Diagnostic Considerations
1Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Insights
Infant mandibular fractures are rare but heal well with conservative treatment due to the mandible
Area of Science:
- Pediatric dentistry
- Craniofacial surgery
- Pediatric trauma
Background:
- Mandibular fractures are uncommon in infants (<1 year), representing 0.9%-2.6% of pediatric mandibular injuries.
- Infant mandible anatomy (elasticity, less trauma exposure) contributes to rarity.
- Diagnosis and management are complex due to communication barriers, unfused bones, and developing teeth.
Purpose of the Study:
- To report a case of concurrent mandibular symphysis and condylar fractures in an infant.
- To evaluate the efficacy of conservative management for infant mandibular fractures.
- To emphasize the infant mandible's remodeling potential.
Main Methods:
- A 3-month-old infant with mandibular fractures after a fall.
- Computed tomography (CT) confirmed a symphyseal greenstick fracture and a minimally displaced condylar fracture.
- Conservative management was chosen due to age, fracture type, and remodeling capacity.
Main Results:
- Three-month follow-up showed excellent bony remodeling without surgery.
- No functional impairment or developmental delay was observed.
- Distinguishing fractures from non-union is critical.
Conclusions:
- The infant mandible possesses significant remodeling potential.
- Conservative treatment is effective for select infant mandibular fractures.
- Long-term monitoring is essential for potential growth disturbances.
Abstract:
Mandibular fractures are rare in infants under one year of age, accounting for only 0.9%-2.6% of pediatric mandibular injuries. Their infrequency is due to the unique anatomical and developmental features of the infant mandible, including increased bone elasticity and minimal exposure to high-impact trauma. Diagnosis and management are often challenging, particularly given the difficulty in symptom communication, presence of unfused skeletal structures, and developing tooth buds. We described a case of a 3-month-old infant who sustained concurrent fractures of the mandibular symphysis and left condylar head following an accidental fall from a diaper-changing table. Computed tomography revealed a greenstick fracture at the symphysis and a minimally displaced condylar fracture. In consideration of the patient's age, fracture type, and high remodeling capacity, conservative management was selected. Clinical and radiographic follow-up over three months demonstrated excellent bony remodeling without any surgical intervention. There was no functional impairment or developmental delay. This case highlights the substantial remodeling potential of the infant mandible and supports the efficacy of conservative treatment in selected cases. It also underscores the importance of distinguishing true fractures from developmental non-union in the symphyseal region. Long-term follow-up until the completion of mandibular growth remains crucial to detect potential growth disturbances.
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