Temporomandibular joint dysfunction after mandibular fracture in children: a 10-year review.

Arch Otolaryngol Head Neck Surg. 2011 Jan;137(1):10-4.
Temporomandibular joint dysfunction after mandibular fracture in children: a 10-year review.

Leuin SC, Frydendall E, Gao D, Chan KH.
SourceDepartment of Otolaryngology, University of Colorado Denver, USA. sleuin@gmail.com
Abstract

OBJECTIVES:

To collect demographic and clinical data on pediatric mandibular fractures and toassess temporomandibular joint (TMJ) dysfunction in patients with condylar and subcondylar (C/SC) fractures.
DESIGN:

Retrospective case series of pediatric mandibular fractures (1999-2009) withfollow-up telephone questionnaire of patients with C/SC fractures. Collected data included age, gender, unilateral vs bilateral C/SC fracture, presence of concomitant fracture, velocity of injury, andtreatment modality.
SETTING:

Tertiary care children's hospital.
PATIENTS:

Of 164 patients with mandibular fractures, 83 (50.6%) had C/SC fractures, of which 45 (54.2%) completed the questionnaire.MAIN OUTCOME MEASURES:

Helkimo Anamnestic Dysfunction Index (A(i)) quantification of TMJ dysfunction after C/SC fracture and treatment modality of C/SC fractures.
RESULTS:

Of the 164patients, 122 (74.4%) were male (median age, 10.4 years; age range, 0.6-19.0 years). Of the 83 patients with C/SC fractures, 61 (73.5%) were male (median age, 9.1 years; age range, 1.1-18.7 years); 66 (79.5%)had unilateral fractures and 17 (20.5%) had bilateral fractures. The A(i) distribution of the 45 patients who completed the questionnaire was as follows: 15 (33.3%) none, 6 (13.3%) mild, and 24(53.3%) severe. Females have more severe dysfunction than do males (95% confidence interval, 1.6-140.0; P = .02). No other significant predictors of treatment modality or TMJ dysfunction were identified.Patients with bilateral fracture are 8.1 times (95% confidence interval, 1.0-66.1 times; P = .05) more likely to have closed reduction than are those with unilateral fracture.
CONCLUSIONS:

This...