[Functional treatment of children subcondylar fractures: An axiographic assessment].
BACKGROUND
Subcondylar fractures are common in children. Occlusion disorders resulting from these fractures in deciduous or mixed dentition do not have as much impact as in adults due to alveolar adaption possibilities. Functional treatment allows for good functional results, but does not treat the dynamic shortening of the ramus. The objective of this study was to evaluate the axiographic condylar slope changes after subcondylar fracture in children.


METHODS
A prospective study was conducted from 2010 to 2015, including all the under-18 patients presenting with a subcondylar fracture. Examination by mean of a Quick Axis axiograph measured the length of propulsion and the condylar inclination on both sides. The main evaluation criterion was the amount of condylar inclination decrease on the fractured side.


RESULTS
Twelve patients (mean age: 10.42; 5-16) were included. Eleven children had a loss of condylar inclination on the fractured side without occlusion disorders at 33.2 months on average (3-144 months) after the initial trauma. Only one patient had symmetric axiographies without loss of condylar inclination on the fractured side.


CONCLUSIONS
Dynamic shortening of the ramus on the side of the subcondylar fracture is consistent at short and medium terms in children. Surgical treatment may be the solution for avoiding this dynamic disorder of the mandible and should be evaluated.
Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
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Vo Quang
Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
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Dichamp
Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
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Tomat
Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France.
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Vazquez
Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France.
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Picard
Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France. Electronic address: natacha.kadlub@aphp.fr.
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Kadlub
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003766:Dental Occlusion; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007574:Jaw Relation Record; D008297:Male; D008310:Malocclusion / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D008335:Mandibular Condyle / Q000473:pathology / Q000601:surgery*; D008337:Mandibular Fractures / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*
Axiographie; Axiography; Child; Condyle mandibulaire; Dental occlusion; Enfant; Fracture; Mandibular condyle; Occlusion dentaire