Treatment of pediatric bilateral condylar fractures: A comprehensive analysis

Khattak, Yasir Rehman; Sardar, Tariq; Iqbal, Anjum; Khan, Muhammad Halim; Khan, Ajmal; Ullah, Umer; Ahmad, Iftikhar

doi:10.1016/j.jormas.2022.11.015

Cited by 4 publications

(7 citation statements)

References 101 publications

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“…The literature indicates that there is no consensus regarding the best method(s) for managing BCFs in children. By virtue of their age, this patient population is in an active growth phase with mixed dentition and is undergoing significant bone remodeling 13,14 . The aim of treating such patients is to restore normal function of the TMJ and to facilitate normal occlusion and growth of the mandible 15 .…”

Section: Discussionmentioning

confidence: 99%

“…Many factors will influence treatment decisions, including the child's age and general state of health, level of the fracture, degree of displacement or dislocation, and the presence of associated facial fractures. Overall, treatment options fall under surgical or nonsurgical approaches 13 . However, the general preference for treating pediatric and adolescent patients is to adopt conservative (i.e., nonsurgical) approaches 16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…13 However, the general preference for treating pediatric and adolescent patients is to adopt conservative (i.e., nonsurgical) approaches. 16,17 In a review of 35 published case reports and retrospective studies, Khattak et al 13 analyzed and compared conservative and surgical approaches. The authors reported that many studies demonstrated that, for pediatric BCFs, a composite approach, in which ORIF was performed on one side and intermaxillary fixation on the other.…”

Section: Discussionmentioning

confidence: 99%

“…By virtue of their age, this patient population is in an active growth phase with mixed dentition and is undergoing significant bone remodeling. 13,14 The aim of treating such patients is to restore normal function of the TMJ and to facilitate normal occlusion and growth of the mandible. 15 Many factors will influence treatment decisions, including the child's age and general state of health, level of the fracture, degree of displacement or dislocation, and the presence of associated facial fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, treatment options fall under surgical or nonsurgical approaches. 13 However, the general preference for treating pediatric and adolescent patients is to adopt conservative (i.e., nonsurgical) approaches. 16,17 In a review of 35 published case reports and retrospective studies, Khattak et al 13 analyzed and compared conservative and surgical approaches.…”

Section: Discussionmentioning

confidence: 99%

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Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Nourwali,

Aljohani

2023

Clinical Case Reports

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Key Clinical MessageConservative treatment of bilateral condylar fractures, including intermaxillary fixation using arch bars and elastic bands, yields satisfactory results in pediatric patients. Therefore, the conservative approach should be considered the first line of treatment for bilateral condylar mandibular fractures in pediatric patients.AbstractRoad traffic accidents (RTAs) are considered the leading cause of mortality and morbidity of children and adults in Saudi Arabia. Head injuries and fractures are the most common form of injuries resulting from RTAs, with mandibular fractures being the most common head injury; condylar fractures are the most frequent type of mandibular fracture. A review of the literature reveals diverse opinions about the best approach for treating bilateral condylar fractures in pediatric patients. The findings of the literature review are reported in this study. The case presented here shows the result of adopting a conservative approach to treating a bilateral extracapsular displaced condylar fracture. An elastic band was fixed onto intermaxillary fixation (IMF) screws at the midline upper and lower jaws; the patient was followed up for almost 3 years. The conservative approach yielded excellent results, as both condyles were fully repositioned and healed, without causing any deviation or limitation of the mouth opening. The results of this case support considering the conservative approach as the first line of treatment for bilateral condylar mandibular fractures in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Nourwali,

Aljohani

2023

Clinical Case Reports

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Characteristics of pediatric mandibular condylar fractures in Southwest China: A single‐center and 12‐year retrospective study

Chen,

Liao,

Huo

et al. 2024

Dental Traumatology

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Background/AimMandibular condylar fractures in pediatric patients may exhibit distinct epidemiological characteristics attributed to their unique growth and development phase, as well as various anatomical, physiological, biomechanical, and behavioral factors that differentiate them from adults. This study aimed to investigate the demographics, injurious factors, classifications, clinical manifestations, and treatments of pediatric mandibular condylar fractures, as well as the concomitant injuries in maxillofacial and other body parts.Materials and MethodsThis retrospective study analyzed the clinical data of 189 pediatric patients with mandibular condylar fractures between 2011 and 2022. Variables investigated included age, gender, timing of onset, causes, classification of condylar fracture, concomitant injuries, clinical manifestations, and treatment modalities.ResultsA total of 189 patients, a higher proportion of boys compared to girls was observed, with the highest incidence rate in children aged 1–3 years. They occurred primarily in July, June, and September as well as on Saturdays and Sundays. The most prevalent cause of mandibular condylar fractures was falls from heights in 73 patients (38.62%). Pediatric patients exhibited a higher susceptibility to condylar head fractures. A significant majority (81.48%) of these fractures were accompanied by soft tissue injuries in the maxillofacial region, with the chin being particularly vulnerable to injury. In addition, 61.90% of pediatric patients experienced fractures in other areas of the maxillofacial region, with the mandibular symphysis being the most commonly affected site. Dental trauma predominantly occurred in the anterior region (44.97%). Notably, a substantial proportion (28.04%) of cases also presented with multiple systemic injuries.ConclusionsThe characteristics of pediatric mandibular condylar fractures exhibit distinct features in terms of age, gender, timing of onset, etiology, location and type, the presence of concomitant maxillofacial soft/hard tissue injuries and multiple systemic injuries, as well as clinical manifestations and treatment modalities. Therefore, clinicians should pay special attention to the diagnosis and treatment of pediatric condylar fractures.

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Total temporomandibular joint reconstruction prosthesis in hemifacial microsomia: A systematic review

Arif

Ashraf

Khan

et al. 2023

Orthod Craniofacial Res

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Hypoplastic asymmetry due to hemifacial microsomia (HFM) often represents the most difficult reconstruction in the craniomaxillofacial clinic. Although autogenous grafts are generally used for temporomandibular joint reconstruction (TMJR), the use of TMJR prostheses is not well established. The aim of this review was to identify, collect and analyse the use of extended TMJR (eTMJR) prostheses in patients with HFM, describing clinical features, surgical procedures and postoperative complications. Online searches of all major databases were performed according to PRISMA guidelines. All studies with HFM patients treated with the eTMJR prostheses were included. Descriptive statistics were used for data analysis. A total of 19 studies, including 08 case studies, 06 case series and 05 retrospective cohort studies, met the inclusion criteria, where a total of 42 HFM patients were reported from 18 countries, mostly from the United States (05; 26%). Fifteen of the 42 cases (~36%) were male. The mean ± SD (range) age of patients in all studies was 19.79 ± 5.81 (9‐36) years. The mean ± SD (range) of patient follow‐up was 41.30 ± 35.50 (6‐136) months. A total of 5 (10.6%) patients were implanted with bilateral eTMJR prostheses. The Pruzansky classification was used in 18 (~89.5%) studies, OMENS classification in 01 (~5%) study, whereas no classification was reported in one study. Only 01 (7.1%) study had documented the eTMJR classification for the prosthesis used. In growing patients with or without a history of failed autogenous tissues, TMJR prostheses may provide a viable alternative. Randomized studies with large cohorts are warranted to validate these preliminary results.

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Treatment of pediatric bilateral condylar fractures: A comprehensive analysis

Cited by 4 publications

References 101 publications

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Characteristics of pediatric mandibular condylar fractures in Southwest China: A single‐center and 12‐year retrospective study

Total temporomandibular joint reconstruction prosthesis in hemifacial microsomia: A systematic review

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