Multicentre retrospective study on plate osteosynthesis for non-condylar mandibular fractures in paediatric patients with deciduous, mixed, and permanent dentition: A World Oral Maxillofacial Trauma (WORMAT) project

Abstract

Mandibular fractures are common maxillofacial injuries among children and adolescents, but treatment remains controversial. The aim of this study was to analyse the methods and outcomes of open reduction and internal fixation (ORIF) for non-condylar mandibular fractures in paediatric patients among 14 maxillofacial centres. Patients ≤16 years of age undergoing ORIF for non-condylar mandibular fractures between 2011 and 2022 were included. Age, gender, dentition stage, site and type of fracture, surgical approach, material, thickness, and number of plates, and outcome were recorded. 179 patients (mean age, 11.1 years) reported 120 single and 59 double fractures, 79% involving at least one displaced or comminuted site. Single fractures were preferentially treated with rigid osteosynthesis in all dentition groups (64%), while double fractures with non-rigid osteosynthesis in mixed and permanent dentition patients (59% and 43%) and mixed osteosynthesis in deciduous dentition patients (50%). Mean follow-up was 21 months. Surgical would infection was the most common complication (8.9%), followed by minor malocclusion (1.7%) and osteitis (1.7%). In conclusion, the centres opted for fixation patterns like those recommended for adults, favoring non-rigid or mixed osteosynthesis for double fractures. The low complication rate shows ORIF is effective and safe for non-condylar mandibular fractures in paediatric patients.