Matthew E Pontell1, Eva B Niklinska2, Stephane A Braun1, Nolan Jaeger3, Kevin J Kelly3, Michael S Golinko3. 1. Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. 2. School of Medicine, Vanderbilt University, Nashville, TN, USA. 3. Division of Pediatric Plastic Surgery, Division of Cleft and Craniofacial Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Abstract
Study Design: Pediatric mandible fractures mandate special consideration because of unerupted teeth, mixed dentition, facial growth and the inability to tolerate maxillomandibular fixation. No consensus exists as to whether resorbable or titanium plating systems are superior with regards to clinical outcomes. Objective: This study aims to systematically review and compare the outcomes of both material types in the treatment of pediatric mandible fractures. Methods: After PROSPERO registration, studies from 1990-2020 publishing on outcomes of ORIF of pediatric mandible fractures were systematically reviewed according to PRISMA guidelines. An additional retrospective review was conducted at a pediatric level 1 trauma center. Results: 1,144 patients met inclusion criteria (30.5% resorbable vs. 69.5% titanium). Total complication rate was 13%, and 10% required a second, unplanned operation. Complication rates in the titanium and resorbable groups were not significantly different (14% vs. 10%; P = 0.07), and titanium hardware was more frequently removed on an elective basis (P < 0.001). Condylar/sub-condylar fractures were more often treated with resorbable hardware (P = 0.01); whereas angle fractures were more often treated with titanium hardware (P < 0.001). Within both cohorts, fracture type did not increase the risk of complications, and comparison between groups by anatomic level did not demonstrate any significant difference in complications. Conclusions: Pediatric mandible fractures requiring ORIF are rare, and hardware-specific outcomes data is scarce. This study suggests that titanium and resorbable plating systems are equally safe, but titanium hardware often requires surgical removal. Surgical approach should be tailored by fracture anatomy, age-related concerns and surgeon preference.
Study Design: Pediatric mandible fractures mandate special consideration because of unerupted teeth, mixed dentition, facial growth and the inability to tolerate maxillomandibular fixation. No consensus exists as to whether resorbable or titanium plating systems are superior with regards to clinical outcomes. Objective: This study aims to systematically review and compare the outcomes of both material types in the treatment of pediatric mandible fractures. Methods: After PROSPERO registration, studies from 1990-2020 publishing on outcomes of ORIF of pediatric mandible fractures were systematically reviewed according to PRISMA guidelines. An additional retrospective review was conducted at a pediatric level 1 trauma center. Results: 1,144 patients met inclusion criteria (30.5% resorbable vs. 69.5% titanium). Total complication rate was 13%, and 10% required a second, unplanned operation. Complication rates in the titanium and resorbable groups were not significantly different (14% vs. 10%; P = 0.07), and titanium hardware was more frequently removed on an elective basis (P < 0.001). Condylar/sub-condylar fractures were more often treated with resorbable hardware (P = 0.01); whereas angle fractures were more often treated with titanium hardware (P < 0.001). Within both cohorts, fracture type did not increase the risk of complications, and comparison between groups by anatomic level did not demonstrate any significant difference in complications. Conclusions: Pediatric mandible fractures requiring ORIF are rare, and hardware-specific outcomes data is scarce. This study suggests that titanium and resorbable plating systems are equally safe, but titanium hardware often requires surgical removal. Surgical approach should be tailored by fracture anatomy, age-related concerns and surgeon preference.
Authors: Robert M Laughlin; Michael S Block; Randall Wilk; Randolph B Malloy; John N Kent Journal: J Oral Maxillofac Surg Date: 2007-01 Impact factor: 1.895
Authors: Kaan C Yerit; Sibylle Hainich; Georg Enislidis; Dritan Turhani; Clemens Klug; Gert Wittwer; Michael Ockher; Gerhard Undt; Christian Kermer; Franz Watzinger; Rolf Ewers Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 2005-07
Authors: S Alex Rottgers; Gary Decesare; Mimi Chao; Darren M Smith; James J Cray; Sanjay Naran; Lisa Vecchione; Lorelei Grunwaldt; Joseph E Losee Journal: J Craniofac Surg Date: 2011-07 Impact factor: 1.046