Management of Mandibular Fractures in Infants and Neonates: A Narrative Review of Growth Preservation, Functional Recovery, and Safeguarding.

BACKGROUND

Mandibular fractures in infants and neonates are rare and present distinct diagnostic and management challenges. Most evidence is derived from isolated case reports and small series, and no age-specific guidance exists.

METHODS

A narrative synthesis was conducted using 26 English-language publications (1985-2025) reporting 50 mandibular fractures in children aged ≤ 12 months, including 10 neonates. PubMed (MEDLINE), Scopus and Google Scholar were searched. Data were extracted using the CARE framework to ensure consistency in documenting clinical findings, imaging, management and safeguarding. Themes were organised around diagnosis, imaging, treatment approaches and growth considerations.

RESULTS

Fifty fractures were identified, with a slight male predominance. Falls were the main cause in older infants, while traumatic delivery predominated in neonates. Among 53 fractures with a documented site, symphyseal/parasymphyseal fractures were most frequent (62.3%). Of 36 cases with reported management, 75% were managed conservatively and 25% surgically. Over 90% of cases with follow-up demonstrated normal growth. Safeguarding procedures were documented in 30.7% of reports.

CONCLUSIONS

Favourable outcomes depend on preserving periosteal integrity, supporting function and performing safeguarding assessments when indicated. Diagnosis should be guided primarily by clinical examination, with selective imaging, and management should prioritise conservative, growth-preserving approaches.