ABSTRACT
Over the last 20 years, a revolution in the management of facial fractures has taken
place. Refinements in biocompatible materials of great delicacy and strength along
with advances in our understanding of biomechanics of the face, have rendered complex
injuries consistently amenable to accurate 3-dimensional reconstruction, Furthermore,
with the availability of education in the techniques of internal rigid fixation, these
advanced techniques have become routine practice in adults. However, the suitability
of rigid internal fixation for children remains controversial. There are many concerns
about the effect of implanted hardware in the mandible of a growing child. In addition,
some evidence suggests that the elevation of functional matrix off of bone may result
in alterations in development. The goal is to restore the underlying bony architecture
to its pre-injury position in a stable fashion, with a minimal of aesthetic and functional
impairment. However, in children the treatment of bony injuries is most easily accomplished
by techniques that may adversely effect craniofacial development. While it is not
entirely possible to resolve this dilemma, there exists an extensive body of experimental
and clinical information on the appropriate management of pediatric mandibular fractures
which can be used to formulate a rational treatment plan for most cases. This paper
presents an overview of the contemporary understanding and application of these treatment
principles.
KEY WORDS
pediatric - mandible - fractures - facial growth - fixation techniques
