Saturday, June 15, 2024

Pediatric Mandible Fractures

Background

Compared with adults, fractures of the facial bones and mandible are uncommon in the pediatric age group, particularly those patients younger than 5 years.

The impact of craniofacial trauma is minimized by the reduced inertia, due to the light weight and small size. The force of impact is absorbed by the forehead and the skull rather than the face since the ratio of cranial volume to facial volume is greater in children than adults (8:1 at birth, 4:1 at 5 years vs. 2:1 in adults). Besides, pediatric facial bones are more resistant to fractures due to their higher elasticity, poor pneumatization (by sinuses), thick surrounding adipose tissue, and stabilization of the mandible and maxilla by the unerupted teeth.

Excluding the nasal bones, the mandible is the most frequently fractured facial bone in the pediatric patient. One third of pediatric trauma patients with facial fractures have a mandibular fracture.

See the image below.

Anatomy of the mandible.

Anatomy of the mandible.

The mandible is different from other facial bones in some important respects. In addition to its contribution to facial dimension and symmetry, the mandible has unique and important functional features. The mandible is the only bone in the face that moves in relation to the skull. Additionally, the mandible bears powerful muscular stresses; injury to this bone can be functionally disabling.
Treatment of certain fracture types differs from treatment of similar fractures in adults and depends on the stage of developing dentition of the pediatric patient.

For excellent patient education resources, visit eMedicineHealth’s Oral Health Center. Also, see eMedicineHealth’s patient education articles Broken Jaw and Broken or Knocked-out Teeth.

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