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Transfacial Pin Technique in the Treatment of a Segmented Pediatric Mandibular Fracture With Severe Lateral Displacement of the Body and Ramus
Jacob Grow, Michael Friel, Sunil Tholpady, Roberto Flores
Indiana University
2013-03-15
Presenter: Jacob Grow
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Please make a statement as to how much of the above work represents the original work of the resident.
Director Name: John Coleman
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
BACKGROUND:
Pediatric mandibular fractures present unique reconstructive challenges. We present a case report of a child with a segmented mandibular fracture with severe lateral displacement of the fracture fragment treated with a transfacial pin technique.
METHODS:
A three year-old female presents with a four piece mandibular fracture, encompassing the symphasis, bilateral condylar necks and the left condylar head. The left mandibular body and ramus demonstrated severe lateral displacement. A Steinmann pin was placed in a transfacial manner through the left mandibular angle, posterior to the tongue and through the right angle. An Ivy loop was then placed around the canines and lower incisors of the lower jaw and circum-mandibular wires were applied. The patient remained in MMF for two weeks. The transfacial pin and Ivy loop were removed after 6 weeks.
RESULTS:
The patient tolerated the procedure well. A soft diet was initiated after MMF was removed and while the transfacial pin was in place. After removal of the transfacial pin, the patient demonstrated class I occlusion, normal excursion of the lower jaw and no deviation of the mandible during full excursion. She currently tolerates a normal diet without pain. A follow-up computer tomography demonstrates adequate reduction and bony union at all four fractured areas.
CONCLUSIONS:
Transfacial pin fixation can be a useful treatment option for children with segmented mandibular fractures with significant lateral displacement.
