Treatment of Pediatric Mandibular Fractures Utilizing the Open Cap Splint: A Clinical Study
Author(s): Ali Ahmed Abbood* and Thair A. Lateef Hassan
Background: Mandibular fracture in pediatric patients always presents a challenge with respect to their diagnosis and treatment. As this pediatrics is of a growing age, care should be taken so that later the overall growth pattern of the mandibular skeleton is not disturbed. Although, the incidence and distribution of in pediatric patient’s mandibular fractures is common, there are few reports about this type of trauma in Iraqi people. The aim of this study: To assess the efficiency of open cap splint and circumferential wires in the closed reduction as a treatment modality in mandibular fractures affecting children and teenagers. Materials and Methods: This was a prospective clinical study included 10 pediatric patients presented with mandibular fractures. The age of the patients was divided into two age groups, the first decade aged group for patients younger than 10 years and the second decade aged group is patients with 10-19 years. Both of them were managed using closed reduction with aid of open cap splint and circumferential wire. The descriptive analysis included percentages or the mean ± standard deviation (SD). All investigated variables were analyzed statistically using the chi-square test. Results: The patient’s age was ranged from 2-15 years with a mean of 6.7 years and a standard deviation (SD) of ± 3.6 years. Eight of the patients 80% were in the first decade of life, while the remaining two patients (20%) were in the second decade. Males in this study were higher than females (70% vs 30%) respectively with a male to female ratio of 2.33:1. The most common cause of injury for first decade age group was fall from height in 90% of cases, and the mostly affected site of fracture was the prarsymphyseal region (70%). The results of this study explained that 40% of patients presented with discomfort and 90% of them suffered from pain in the first week after surgery. Conclusion: Mandibular fractures in Pediatric patients reported most frequently in the first decade of life with male predominance. Falls was the most common cause of mandibular fractures. The incidence of mandibular fractures is high in the parasymphyseal region since it was the most affected site. The surgical treatment was indicated in all cases and no major complications encountered, the open cap splint proved to be satisfactory for the surgeon and patients. Most cases were managed using 2 circumferential wires, which was quite enough for effective fixation.