title: Application of biodegradable plates for treating pediatric mandibular fractures.
abstract: OBJECTIVE
  We assessed the clinical results of a biodegradable plate system for the internal fixation of mandibular fractures in children, and observed the imaging features of fracture healing and bone changes around the biodegradable plates and screws during follow-up.
  
  
  METHODS
  We enrolled 39 patients (22 male, 17 female, average age 4 years 10 months) with different mandibular fractures. We used 2.0-mm resorbable plates to repair the fractures. Postoperative follow-up ranged from 6 months to 5 years; average follow-up was 1 year 2 months. The outcome measures identified and assessed included facial symmetry, mouth opening, occlusal relationship, infection, nonunion, malunion, and plate dehiscence.
  
  
  RESULTS
  We fixed 42 fractures with 43 resorbable plates; the fracture site of one patient (aged 11 years 3 months) was fixed with two plates. Two patients developed small fistulas at the intraoral incision 2 months after surgery; the fistulas healed after 1 month without special treatment. In the other patients, the incision healed well, there was facial symmetry, mouth opening was >35 mm, and occlusion was good. Follow-up computed tomography examination data were available for 20 cases, and revealed different degrees of radiolucency indicating that osteolysis had occurred. Radiolucency was observed around the resorbable plates 1 month after the surgery. The extent and depth of the radiolucent region were obvious within 1 year of surgery. In the second year, there were obvious repairs, with the bony defect areas becoming shallower. After 2 years, the bony defect areas had almost disappeared.
  
  
  CONCLUSIONS
  Biodegradable fixation devices are safe and efficient for treating pediatric mandibular fractures. Osteolysis commonly follows biodegradable fixation of pediatric mandibular fractures, and has no adverse effect on fracture healing.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Jingang
authors.initials: J
authors.lastname: An
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Jia
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China. Electronic address: Zhangyi2000@263.net.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Xi
authors.initials: X
authors.lastname: Gong
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: He
mesh_terms: D020341:Absorbable Implants; D001860:Bone Plates; D001863:Bone Screws; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000209:etiology; D003766:Dental Occlusion; D005146:Facial Asymmetry / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D017759:Fractures, Malunited / Q000209:etiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Biodegradable plate; Children; Internal fixation; Mandibular fracture; Osteolysis; PLGA