eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Mandible Fractures in Children: Workup

Author: Russell A Faust, MD, PhD, Consulting Staff, Department of Otolaryngology, Columbus Children's Hospital
Coauthor(s): Abbas A Younes, MD, Assistant Professor, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Assistant Professor, Department of Pediatrics, University of Kentucky College of Medicine; Wendy Gottlieb, MD, Staff Physician, Department of Plastic Surgery, University of Virginia
Contributor Information and Disclosures

Updated: Jun 25, 2009

Workup

Imaging Studies

  • Panorex
    • Panorex is the study of choice. The patient must be cooperative and motionless while the radiograph machine rotates. Patient movement may simulate a fracture. Most available equipment requires the patient to be able to sit upright; therefore, this examination may not be possible in critically ill patients or those with suspected cervical spine injuries. (Some facilities have special equipment for the supine patient.)
    • A series of plain radiograph views may provide similar information and often are easier to obtain in the acute trauma setting.
  • Plain radiography: Standard radiograph views that evaluate the mandible include the following:
    • Lateral oblique view - Provides the best view of the mandible from the condyle to the mental foramen
    • Posteroanterior (PA) view - Can visualize displacement of fractures of the ramus, angle, and body and fractures of the anterior mandible that may be obscured by the vertebral bodies
    • Towne occipitofrontal view - Demonstrates condylar fractures and displacement medially or laterally
    • Mandibular occlusal views - Demonstrate symphyseal displacement
    • Dental radiographs - May prove useful in alveolar fractures or dental root fractures
  • CT scanning
    • Thin-section (£ 3 mm) CT scans through the mandible can be useful.
    • Direct coronal images and/or 3-dimensional or multiplanar reconstructions can help delineate relation of the temporomandibular joint (TMJ).

More on Mandible Fractures in Children

Overview: Mandible Fractures in Children
Workup: Mandible Fractures in Children
Treatment: Mandible Fractures in Children
Follow-up: Mandible Fractures in Children
Multimedia: Mandible Fractures in Children
References
Further Reading
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References

  1. MacLennan WD. Fractures of the mandible in children under the age of six years. Br J Plast Surg. 1956;9:125.

  2. Rowe NL. Fractures of the jaws in children. J Oral Surg. Jul 1969;27(7):497-507. [Medline].

  3. Thoren H, Iizuka T, Hallikainen D. Different patterns of mandibular fractures in children. An analysis of 220 fractures in 157 patients. J Craniomaxillofac Surg. Oct 1992;20(7):292-6. [Medline].

  4. Kaban LB, Mulliken JB, Murray JE. Facial fractures in children: an analysis of 122 fractures in 109 patients. Plast Reconstr Surg. Jan 1977;59(1):15-20. [Medline].

  5. Posnick JC, Wells M, Pron GE. Pediatric facial fractures: evolving patterns of treatment. J Oral Maxillofac Surg. Aug 1993;51(8):836-44; discussion 844-5. [Medline].

  6. Myall RW. Management of mandibular fractures in children. Oral Maxillofac Surg Clin North Am. May 2009;21(2):197-201, vi. [Medline].

  7. Cole P, Kaufman Y, Izaddoost S, Hatef DA, Hollier L. Principles of pediatric mandibular fracture management. Plast Reconstr Surg. Mar 2009;123(3):1022-4. [Medline].

  8. Kushner GM, Tiwana PS. Fractures of the growing mandible. Atlas Oral Maxillofac Surg Clin North Am. Mar 2009;17(1):81-91. [Medline].

  9. Eppley BL. Use of resorbable plates and screws in pediatric facial fractures. J Oral Maxillofac Surg. Mar 2005;63(3):385-91. [Medline].

  10. Poore MC, Penna KJ. The use of resorbable hardware for fixation of pediatric mandible fracture. Case report. N Y State Dent J. Jun-Jul 2008;74(4):58-61. [Medline].

  11. MacLennan WD. Consideration of 180 cases of typical fractures of the mandibular condylar process. Brit J Plast Surg. 1952;5:122.

  12. Landes CA, Day K, Glasl B, Ludwig B, Sader R, Kovács AF. Prospective evaluation of closed treatment of nondisplaced and nondislocated mandibular condyle fractures versus open reposition and rigid fixation of displaced and dislocated fractures in children. J Oral Maxillofac Surg. Jun 2008;66(6):1184-93. [Medline].

  13. Tanaka N, Uchide N, Suzuki K. Maxillofacial fractures in children. J Craniomaxillofac Surg. Oct 1993;21(7):289-93. [Medline].

  14. Imahara SD, Hopper RA, Wang J, Rivara FP, Klein MB. Patterns and outcomes of pediatric facial fractures in the United States: a survey of the National Trauma Data Bank. J Am Coll Surg. Nov 2008;207(5):710-6. [Medline].

  15. Leake D, Doykos J 3d, Habal MB. Long-term follow-up of fractures of the mandibular condyle in children. Plast Reconstr Surg. Feb 1971;47(2):127-31. [Medline].

  16. Norholt SE, Krishnan V, Sindet-Pedersen S. Pediatric condylar fractures: a long-term follow-up study of 55 patients. J Oral Maxillofac Surg. Dec 1993;51(12):1302-10. [Medline].

  17. McGuirt WF, Salisbury PL 3d. Mandibular fractures. Their effect on growth and dentition. Arch Otolaryngol Head Neck Surg. Mar 1987;113(3):257-61. [Medline].

  18. [Guideline] American Academy of Pediatric Dentistry (AAPD). Clinical guideline on pediatric oral surgery. 2005;9. [Full Text].

  19. Dufresne CR. Pediatric facial trauma. In: McCarthy JG, ed. Plastic Surgery. Vol 2. Philadelphia, Pa:. WB Saunders;1990.

  20. Hardt N, Gottsauner A. The treatment of mandibular fractures in children. J Craniomaxillofac Surg. Jul 1993;21(5):214-9. [Medline].

  21. Jamerson RE, White JA. Management of pediatric mandibular fractures. J La State Med Soc. Mar 1990;142(3):11-3. [Medline].

  22. Koltai PJ, Rabkin D. Management of facial trauma in children. Pediatr Clin North Am. Dec 1996;43(6):1253-75. [Medline].

  23. Maniglia AJ, Kline SN. Maxillofacial trauma in the pediatric age group. Otolaryngol Clin North Am. Aug 1983;16(3):717-30. [Medline].

  24. Pogrel MA, Kaban LB. Mandibular fracture. In: Haban MB, Ariyan S, eds. Facial Fractures. Toronto, Canada:. BC Decker;1989.

  25. Polayes IM. Facial fractures in the pediatric patient. In: Habal MB, Ariayn S, eds. Facial Fractures. Toronto, Canada:. BC Decker;1989.

  26. Schweinfurth JM, Koltai PJ. Pediatric mandibular fractures. Facial Plast Surg. 1998;14(1):31-44. [Medline].

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Further Reading

Clinical guideline

Clinical guideline on pediatric oral surgery. 18
American Academy of Pediatric Dentistry - Professional Association.  2005.  9 pages.  NGC:004444

Clinical trial

Champy Versus AO for Mandible Fractures


Related eMedicine topics

 Mandible Fractures, General Principles and Occlusion

Mandible, Fractures

Facial Trauma, Mandibular Fractures

Facial Fractures

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Keywords

mandible fractures in children, broken jaw, mandibular fractures, condyle fractures, condylar fractures, arch fractures, body fractures, angle fractures, dentoalveolar fractures

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Contributor Information and Disclosures

Author

Russell A Faust, MD, PhD, Consulting Staff, Department of Otolaryngology, Columbus Children's Hospital
Russell A Faust, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Legal Medicine, American Laryngological Rhinological and Otological Society, American Rhinologic Society, American Society for Head and Neck Surgery, and American Society of Law Medicine and Ethics
Disclosure: Nothing to disclose.

Coauthor(s)

Abbas A Younes, MD, Assistant Professor, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Assistant Professor, Department of Pediatrics, University of Kentucky College of Medicine
Abbas A Younes, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery
Disclosure: Nothing to disclose.

Wendy Gottlieb, MD, Staff Physician, Department of Plastic Surgery, University of Virginia
Wendy Gottlieb, MD is a member of the following medical societies: American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Todd Schneiderman, MD, Consulting Surgeon, Atlanta Ear Nose and Throat Associates
Todd Schneiderman, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Rhinologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Gregory C Allen, MD, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Gregory C Allen, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Laryngological Rhinological and Otological Society, American Medical Association, Christian Medical & Dental Society, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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