Surgical protocols and outcome for the treatment of maxillofacial fractures in children: 9 years' experience.
Trauma and facial fractures in a population of children have been analysed in several studies mainly regarding their incidence and much less their treatment modalities.


OBJECTIVE
The aim of this study was to retrospectively analyse the treatment methods and outcome of facial fractures in children and young adolescents during the last decade and to discuss findings and propose treatment protocols.


METHODS
Patients of the Paediatric Maxillofacial department, treated for fractures of the facial skeleton were included in the study. Open reduction and osteosynthesis plate fixation (titanium and resorbable material) was the main treatment method with conservative treatment saved for selected cases. Titanium plates were removed after bone healing. Intermaxillary fixation (IMF) was not used regularly in mandibular fractures, with the exception of condylar fractures.


RESULTS
156 children and young adolescents with 208 fracture sites in total were treated. 139 fracture sites (66.8%) were treated with open reduction and 69 conservatively. The mandible was affected in 49.0% of the cases, the maxilla in 21.2% (both with the alveolar process fractures included), the zygomatic complex in 10.1%, the orbital walls in 9.6%. There were 38 alveolar process fractures.


CONCLUSIONS
The results of the fracture treatment verified the usefulness of open reduction and plate fixation in children. There was no need for wire suspension and only occasional need for IMF. Closed reduction was selectively applied in condylar fractures and dento-alveolar trauma.
Iatrou
Ioannis
I
University Department of Oral and Maxillofacial Surgery at the Children's Hospital, A. & P. Kyriakou, Dental School University of Athens, Greece. iiatrou@dent.uoa.gr
Theologie-Lygidakis
Nadia
N
Tzerbos
Fotios
F
D000293:Adolescent; D017677:Age Distribution; D000539:Alveolar Process / Q000293:injuries; D001860:Bone Plates; D002648:Child; D020878:Device Removal; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D019248:Jaw Fixation Techniques; D007572:Jaw Fractures / Q000601:surgery*; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries; D009917:Orbital Fractures / Q000601:surgery*; D012189:Retrospective Studies; D014025:Titanium; D015051:Zygomatic Fractures / Q000601:surgery*
D014025:Titanium