Causes, Risks, and Treatment of Mandibular or Lower Jaw Fractures in Children

Fractures of the Lower Jaw Bone in Children

Fractures of the mandible or jaw and facial bones are not common in children, particularly those under the age of five years. Children are light in weight and small in size and so have reduced inertia in falls and accidents, protecting their bones and organs from high degrees of injury. Their bones are also more elastic and have more resistance to fractures. When the facial bones do suffer forceful injury, the impact is usually absorbed by the forehead and the skull bones instead of the finer facial bones. Of the facial bones the mandible is the most frequently fractured bone in children, making up one third of all facial fractures.

Anatomy of the Mandible Bone

The mandible is also called the inferior maxillary bone and makes up the lower jaw of the face. It consists of a curved horizontal body which makes up the chin, two perpendicular rami portions, the alveolar process which holds the lower teeth, the condyle which makes the temporomandibular joint with the temporal bone of the skull, and the coronoid processes which attach to the temporalis muscle.

Causes

The male to female ratio of mandibular fractures in children is 2.4:1.0, likely because this type of fracture is usually caused by accidents and falls. Most fractures occur on only one side of the mandible bone up to 36 percent of cases involve the condoyle area. Trauma caused by motor vehicle accidents and falls is among the most common causes, followed by recreational and sports injuries such as bicycle accidents in children. Other causes include violence and physical abuse as well as trauma suffered from ammunition, shrapnel, and flying debris in areas of war and conflict.

In young children the jaw bone is weakened by developing teeth and fractures may occur along the areas of developing tooth tracts in an accident or injury.

Risks Due to Fractures

The mandible is the only bone in the face that moves and is joined to the skull with powerful ligaments and muscles that are needed for chewing and biting power. Hence, injury to this bone can be severely disabling as well as physically damaging to the face. Developing teeth in the line of a fracture may become deformed. In severe and rare fractures that affect the growth centers of bone, the mandible may not heal and grow correctly causing facial deformity. Bone infections may also occur in cases of mandibular fractures in children.

Children suffering mandibular fractures are immediately assessed and treated for any airway blockage as the face and mouth has sustained direct trauma and swelling. Blood and bone chips may also cause choking and suction and clearing of the airway is the first step in treating the child.

Treatment and Recovery

Unlike adults, young children have an abundance of cartilaginous bone and a thick tissue covering on their developing bones. As a result, “greenstick” fractures in which the fractures do not go all the way through, are common. This allows fast healing with little or no bone scarring or permanent damage in most cases. Treatment may include simple splints made of acrylic or metal.