Iida S, Matsuya T Paediatric maxillofacial fractures: their aetiological characters and fracture patterns. J Craniomaxillofac Surg. 2002; 30:237-241
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The use of orthodontics in the management of a bilateral condylar fracture in a child

From Volume 17, Issue 1, January 2024 | Pages 7-10


Ian Murphy

BDS, MFDS (RCS Ed), MClinDent, MOrth (RCS Eng), FDS (Orth) RCS, PGCertClinEd, MFDS RCS Ed, MOrth RCS Eng

Post-CCST Orthodontics, Department of Orthodontics, Royal Surrey County Hospital, Guildford

Articles by Ian Murphy

Email Ian Murphy

Nigel Taylor

MDSc, BDS, FDS RCS(Ed), MOrth RCs(Ed), MDSc, BDS, FDS RCS(Ed), FDS RCS(Eng), FDTFed RCS(Ed), M'Orth RCS(Ed), D'Orth RCS(Eng), Consultant Orthodontist

Consultant Orthodontist, Royal Surrey County Hospital, Guildford, UK

Articles by Nigel Taylor


Mandibular fractures in children are different to those in adults. Greenstick fractures are more commonplace, and displacement less frequently encountered. They are mostly treated conservatively; however, if the occlusion is altered, then reduction will be required. Closed reduction is normally favoured in children because open surgical reduction and internal fixation may impair future growth. Closed reduction is often carried out with arch bars or splints. These may be traumatic and painful for the child. This case report describes the case of a 12-year-old boy who presented with bilateral condylar fractures with displacement and deranged occlusion. Minimal fixed appliance treatment was used to reduce the fractures and restore him to his pre-injury occlusion.

CPD/Clinical Relevance: Minimal orthodontic treatment can be used to reduce a bilateral condylar fracture with displacement in paediatric mandibular fractures.


Fractures of the mandible are the most frequent facial skeletal injury as a result of facial trauma in children.1 In paediatric mandibular fractures, the condyle is the most common fracture site, followed by the symphysis/parasymphysis, the body, and then the angle.2,3

Condylar fractures mostly occur via blunt force to the anterior mandible transmitted to the condylar region. Involvement of the temporomandibular joint (TMJ) in the fracture, or excessive immobilization in treatment, may cause altered occlusion and/or ankylosis of the joint.4

The condylar cartilage is not a primary growth centre for the mandible, but still has an adaptive response.5 Therefore, trauma to the condylar region can also result in underdevelopment of the mandible. It is estimated that 75% of children who undergo a condylar fracture have normal mandibular growth.6

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