Conservative management of pediatric mandibular distal fractures -a retrospective study.

BACKGROUND/AIM Pediatric mandibular distal fractures presents unique treatment challenges which are usually managed with open reduction and internal fixation (ORIF) with the risk of developing tooth bud injuries. A conservative management through Maxillo-mandibular fixation (MMF) with orthodontic bracket-elastic as out-patient department (OPD) service has been used for these fractures presenting with derangement of occlusion. The aim of this study was to retrospectively analyze MMF with orthodontic bracket-elastic as a treatment method and its outcome for management of pediatric mandibular distal fractures. METHODOLOGY Data of seventeen pediatric cases diagnosed with displaced mandibular distal fractures managed with MMF with orthodontic bracket-elastic over a period of 5 years were analyzed. In this technique, two weeks of immobilization and one week for guiding elastics were used. RESULTS The mean age of patients was 7.6 ± 1.6 years with a mean follow up of 24 months. All fractures healed uneventfully with satisfactory occlusion. The cases included 23.5% minimally displaced, and 64.7% moderately displaced and 11.8% significantly displaced fractures with step deformity with successful remodeling of the lower border contours over a duration of 18 months ±1 month. The developing tooth buds in the fracture line showed no complications except for root dilacerations/malformation (n=3). CONCLUSION MMF with orthodontic bracket-elastic is a viable and conservative technique for the management of pediatric mandibular distal fractures which need to be verified through randomized trials for generalization of the results.