title: 215 mandible fractures in 120 children: demographics, treatment, outcomes, and early growth data.
abstract: BACKGROUND
  Optimal management of pediatric mandible fractures demands that the practitioner balance reduction and fixation with preservation of growth potential and function. The ideal synthesis of these goals has not yet been defined. The authors catalogue their experience with pediatric mandible fractures at a major pediatric teaching hospital with reference to demographics, injury type, treatment, and outcomes to inform future management of these injuries.
  
  
  METHODS
  Demographics, management, and outcomes of pediatric mandible fractures presenting over 10 years at a pediatric trauma center were assessed. Cephalometric analysis was conducted. Relationships among demographics, fracture type, management, outcomes, and growth were explored.
  
  
  RESULTS
  Two hundred fifteen mandible fractures in 120 patients younger than 18 years were analyzed (average follow-up, 19.5 months). The condylar head and neck were fractured most frequently. Operative management was significantly more likely for children older than 12 years (p<0.05). Operative management and multiple fractures were significantly associated with a higher rate of adverse outcomes (p<0.05), but no adverse outcomes were considered to significantly affect mandibular function by patient or surgeon. No significant growth differences existed on cephalometric analysis between our cohort and age- and sex-matched controls (p>0.05).
  
  
  CONCLUSIONS
  This study reports the demographics, treatment, and early follow-up of a sizable cohort of pediatric mandible fractures. Management principles for these injuries are outlined. Although definitive recommendations must be withheld until longer follow-up is available, the data presented here show that the treatment protocols used at the authors' center have yielded largely uncompromised mandibular function and growth thus far.
authors.affiliation: Pittsburgh, Pa. From the Children's Hospital of Pittsburgh.
authors.forename: Darren M
authors.initials: DM
authors.lastname: Smith
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bykowski
authors.forename: James J
authors.initials: JJ
authors.lastname: Cray
authors.forename: Sanjay
authors.initials: S
authors.lastname: Naran
authors.forename: S Alex
authors.initials: SA
authors.lastname: Rottgers
authors.forename: Sameer
authors.initials: S
authors.lastname: Shakir
authors.forename: Lisa
authors.initials: L
authors.lastname: Vecchione
authors.forename: Lindsay
authors.initials: L
authors.lastname: Schuster
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Losee
mesh_terms: D000367:Age Factors; D015984:Causality; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007223:Infant; D008297:Male; D008334:Mandible / Q000254:growth & development*; D008337:Mandibular Fractures / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000453:epidemiology / Q000209:etiology