Repair of a pediatric bilateral condylar and symphyseal fracture using a transfacial Steinman pin.
The proper management of complex pediatric mandibular fractures remains a topic of debate because of the relatively uncommon presentation of these fractures, combined with concerns related with deciduous teeth, tooth buds, and growth inhibition. In this current study, we present a novel approach to the repair of bilateral condylar fractures with concomitant symphyseal fracture in a 4-year-old girl. Manual closed reduction was first obtained, followed by placement of a transfacial Steinman pin through the angles of the mandible and placement of circummandibular wires. Maxillomandibular fixation remained for 2 weeks and the Steinman pin was removed after 11 weeks. At 3 months of postsurgical follow-up, the patient displayed class I occlusion, facial symmetry, full range of jaw motion, and absence of deviation or pain on full oral excursion. Radiographic findings also revealed complete resolution of the symphyseal fracture with appropriate condylar healing and alignment.
From the *Indiana University School of Medicine; and Division of Plastic Surgery, †Riley Hospital for Children, Indiana University Health, Indianapolis, Indiana.
Jacob N
JN
Grow
Roberto L
RL
Flores
Sunil S
SS
Tholpady
D001858:Bone Nails; D002675:Child, Preschool; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D021621:Imaging, Three-Dimensional; D019248:Jaw Fixation Techniques; D008311:Malocclusion, Angle Class I; D008334:Mandible / Q000601:surgery; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery*; D008337:Mandibular Fractures / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014094:Tooth, Deciduous / Q000601:surgery