title: Pediatric mandibular fractures: a free hand technique.
abstract: BACKGROUND
  The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition.
  
  
  OBJECTIVE
  To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues.
  
  
  METHODS
  A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.).
  
  
  RESULTS
  Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did.
  
  
  CONCLUSIONS
  We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.
authors.affiliation: Division of Plastic Surgery, Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, DC 20007, USA.
authors.forename: S P
authors.initials: SP
authors.lastname: Davison
authors.forename: M S
authors.initials: MS
authors.lastname: Clifton
authors.forename: M N
authors.initials: MN
authors.lastname: Davison
authors.forename: M
authors.initials: M
authors.lastname: Hedrick
authors.forename: G
authors.initials: G
authors.lastname: Sotereanos
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies