Change of the Inclination Angle in a Greenstick Fracture of the Mandibular Subcondyle Treated With Intermaxillary Fixation in a Child.

This paper presents the outcomes of a conservative approach to greenstick condylar fracture treatment in a child. Serial changes of the inclination angle were measured in a greenstick fracture of the mandibular subcondyle treated with intermaxillary fixation (IMF).A 7-year-old girl presented with the complaint of pain on her chin. She had fallen from a 3-m height and hit her face on the floor. She had limited mouth-opening of one finger breadth. Panoramic radiography and computed tomography confirmed a green-stick (incomplete) fracture of the right condyle, in which the lateral side of the bone was fractured and the medial side was bent. The medial inclination was approximately 67.9°. On the second posttrauma day, IMF was performed using arch-bars and a prefabricated occlusal stop. Serial Town's views were taken. The inclination of the fractured condyle was measured and compared with the contralateral side. The difference in inclination angles (DI) between the fractured and contralateral sides was plotted over time. In SPSS version 19.0, an exponential regression model was constructed.In this child, a green-stick (incomplete) fracture of the condyle (68.0° inclination) was treated with IMF and a prefabricated occlusal stop. On day 321 post-IMF, the inclination angle had decreased to 31.1°, only 6.8° greater than the contralateral side. The DI was fitted to an exponential regression model (y = 37.019e-0.006x, R2 = 0.703, P < 0.001).This case shows that even in children, a greenstick fracture of the mandibular condyle can be treated by vertical lengthening using an occlusal stop and IMF.