J Korean Assoc Oral Maxillofac Surg.  2018 Dec;44(6):269-274. 10.5125/jkaoms.2018.44.6.269.

A retrospective study of mandibular fractures in children

• Mukhopadhyay S

• KMID: 2467173
• DOI: http://doi.org/10.5125/jkaoms.2018.44.6.269

Abstract

OBJECTIVES
The incidence and patterns of mandibular fractures vary by country and population age. This retrospective study evaluated the etiologies and patterns of mandibular fractures in children.
MATERIALS AND METHODS
The clinical records of 89 children (45 males and 44 females) aged 0 to 12 years who presented with mandibular fractures from July 2012 to June 2016 were retrospectively reviewed. The sex, patient age, site of fracture, etiology of trauma, and monthly variations of the fractures were recorded. Descriptive statistics, the z-test and chi-square test were used for statistical analysis and the P-value was set at < 0.05.
RESULTS
Eighty-nine children (male-to-female ratio 1.02:1) sustained 131 mandibular fractures. Within the study sample, the 6 to 9 year age group most frequently experienced fractures (47.3%). Falls and road traffic accidents (RTA) were the two most common etiological factors that accounted for 44.9% and 24.7% of cases. The condylar fracture was the most common anatomical location (38.9%) followed by the angle (20.6%), parasymphysis (18.3%), body (15.3%), and symphysis (5.3%). A single fracture (51.7%) was more common than multiple fractures (48.3%). The month-wise distribution of mandibular fractures was fairly constant.
CONCLUSION
The condylar region was the most common anatomic site for fractures; in addition, a fall and RTA were the major etiological factors for mandibular fractures. A single fracture was observed in 51.7% of patients while multiple fracture lines accounted for 48.3% of cases.

Keyword

Mandibular fractures; Child; Epidemiology

MeSH Terms

Accidental Falls
Accidents, Traffic
Child*
Epidemiology
Fractures, Multiple
Humans
Incidence
Male
Mandibular Fractures*
Retrospective Studies*

Reference

1. Marano R, de Oliveira Neto P, Sakugawa KO, Zanetti LSS, de Moraes Z. Mandibular fractures in children less than 3 years: a rare case report. Rev Port Estomatol Med Dent Cir Maxilofac. 2013; 54:115–176.

2. Haug RH, Foss J. Maxillofacial injuries in pediatric patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90:126–134. PMID: 10936829.

3. Almahdi HM, Higzi MA. Maxillofacial fractures among Sudanese children at Khartoum Dental Teaching Hospital. BMC Res Notes. 2016; 9:120. PMID: 26905310.

4. Muñante-Cárdenas JL, Olate S, Asprino L, de Albergaria Barbosa JR, de Moraes M, Moreira RW. Pattern and treatment of facial trauma in pediatric and adolescent patients. J Craniofac Surg. 2011; 22:1251–1255. PMID: 21772206.

5. Collao-González C, Carrasco-Labra A, Sung-Hsieh HH, Cortés-Araya J. Epidemiology of pediatric facial trauma in Chile: a retrospective study of 7,617 cases in 3 years. Med Oral Patol Oral Cir Bucal. 2014; 19:e99–e105. PMID: 23986019.

6. Pandey S, Roychoudhury A, Bhutia O, Singhal M, Sagar S, Pandey RM. Study of the pattern of maxillofacial fractures seen at a tertiary care hospital in North India. J Maxillofac Oral Surg. 2015; 14:32–39.

7. Singhal R, Singh V, Bhagol A, Agrawal A, Kumar P. Pediatric maxillofacial injuries - if a new look is required? Int J Pediatr Otorhinolaryngol. 2013; 77:1333–1336. PMID: 23800474.

8. Joshi SR, Saluja H, Pendyala GS, Chaudhari S, Mahindra U, Kini Y. Pattern and prevalence of maxillofacial fractures in rural children of central Maharashtra, India. A retrospective study. J Maxillofac Oral Surg. 2013; 12:307–311. PMID: 24431857.

9. Kumar GB, Dhupar V, Akkara F, Kumar SP. Patterns of maxillofacial fractures in goa. J Maxillofac Oral Surg. 2015; 14:138–141.

10. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer H. Cranio-maxillofacal trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg. 2003; 31:51–61. PMID: 12553928.

11. Abdullah WA, Al-Mutairi K, Al-Ali Y, Al-Soghier A, Al-Shnwani A. Patterns and etiology of maxillofacial fractures in Riyadh city, Saudi Arabia. Saudi Dent J. 2013; 25:33–38. PMID: 23960553.

12. Ferreira P, Marques M, Pinho C, Rodrigues J, Reis J, Amarante J. Midfacial fractures in children and adolescents: a review of 492 cases. Br J Oral Maxillofac Surg. 2004; 42:501–505. PMID: 15544878.

13. Verma S, Chambers I. Update on patterns of mandibular fracture in Tasmania, Australia. Br J Oral Maxillofac Surg. 2015; 53:74–77. PMID: 25453253.

14. Killey HC. Killey's fractures. In : Banks P, editor. Killey's fractures of the mandible. 3rd ed. London: Wright;1988. p. 15–28.

15. Cole P, Kaufman Y, Hollier LH Jr. Managing the pediatric facial fracture. Craniomaxillofac Trauma Reconstr. 2009; 2:77–83. PMID: 22110800.

16. Namdev R, Jindal A, Bhargava S, Dutta S, Singhal P, Grewal P. Patterns of mandible fracture in children under 12 years in a district trauma center in India. Dent Traumatol. 2016; 32:32–36. PMID: 26149608.

17. Owusu JA, Bellile E, Moyer JS, Sidman JD. Patterns of pediatric mandible fractures in the United States. JAMA Facial Plast Surg. 2016; 18:37–41. PMID: 26470008.

18. Kumaraswamy SV, Madan N, Keerthi R, Singh DS. Pediatric injuries in maxillofacial trauma: a 5 year study. J Maxillofac Oral Surg. 2009; 8:150–153. PMID: 23139495.

19. Atilgan S, Erol B, Yaman F, Yilmaz N, Ucan MC. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey. J Appl Oral Sci. 2010; 18:17–22. PMID: 20379677.

20. Holland AJ, Broome C, Steinberg A, Cass DT. Facial fractures in children. Pediatr Emerg Care. 2001; 17:157–160. PMID: 11437137.

21. Muraoka M, Nakai Y, Nakagawa K, Yoshioka N, Nakaki Y, Yabe T, et al. Fifteen-year statistics and observation of facial bone fracture. Osaka City Med J. 1995; 41:49–61. PMID: 8778646.

22. Schlievert R. Infant mandibular fractures: are you considering child abuse? Pediatr Emerg Care. 2006; 22:181–183. PMID: 16628104.

23. Knoche JW, LeBlanc KK, King TW, Knox BL. An infant with a unilateral mandibular fracture: when to consider nonaccidental trauma. Clin Pediatr (Phila). 2012; 51:404–407. PMID: 22456490.

24. Fasola AO, Obiechina AE, Arotiba JT. Fractures of the mandible in children. East Afr Med J. 2001; 78:616–618. PMID: 12219970.

25. Tanaka N, Uchide N, Suzuki K, Tashiro T, Tomitsuka K, Kimijima Y, et al. Maxillofacial fractures in children. J Craniomaxillofac Surg. 1993; 21:289–293. PMID: 8263213.

26. Bamjee Y. Paediatric maxillofacial trauma. J Dent Assoc S Afr. 1996; 51:750–753. PMID: 9462032.

27. Shi J, Chen Z, Xu B. Causes and treatment of mandibular and condylar fractures in children and adolescents: a review of 104 cases. JAMA Otolaryngol Head Neck Surg. 2014; 140:203–207. PMID: 24408746.

28. Thorén H, Iso-Kungas P, Iizuka T, Lindqvist C, Törnwall J. Changing trends in causes and patterns of facial fractures in children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107:318–324. PMID: 18964157.

29. Jung HW, Lee BS, Kwon YD, Choi BJ, Lee JW, Lee HW, et al. Retrospective clinical study of mandible fractures. J Korean Assoc Oral Maxillofac Surg. 2014; 40:21–26. PMID: 24627839.

30. Posnick JC, Wells M, Pron GE. Pediatric facial fractures: evolving patterns of treatment. J Oral Maxillofac Surg. 1993; 51:836–844. discussion 844-5. PMID: 8336220.

31. Burlini D, Conti G, Amadori F, Bardellini E, De Giuli C. Management of paediatric maxillofacial fractures: conventional methods and resorbable materials. Eur J Paediatr Dent. 2015; 16:24–28. PMID: 25793949.