Nonsurgical management of pediatric condylar fractures: cases reports

Lee, Jeong Kun; Park, Ik Su; Noh, Yang Ho; Kim, Dong Woo; Kim, Woo Hyong; Lee, Hee Chul

Abstract

Of all facial fractures in children, condylar fractures have the greatest propensity to produce a growth disturbance.The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complications such as facial asymmetry, TMJ pain, limiation of motion and deflection, midline deviation of the dental arch. So, the goal of managing condyle fractures in the growing patient is to restore mandibular symmetry, occlusion, function without interfering with future growth. Commonly, fracture teatment aims at restoring function through repositioning and rigid fixation of the bony fragments. However, the generally preferred management of condylar fractures in growing children is nonsurgical. So, we present the clinical and radiographic follow-up results of 4 condylar fractures in pedi atric patients whom we managed in conservative and functional method. We can summarize our protocol in management of pediatric condylar fracture as the following: The IMF using acrylic resin splint with circumferential wiring was performed for 1 or 2 weeks. After releasing IMF, the active physical therapy was done with guiding elastic band. Opening deviation was controlled by mannual pressure of surgeon or parents for 2 weeks. When unstable occlusion or functional problem remained, functional appliance after construction bite registration was used for several months.