Titanium Plates Hinder the Development of the Mandible in Pediatric Patients.

Abstract

Objective: The treatment of severe mandibular comminuted fractures in children is a challenge. It usually requires open reduction and internal fixation. However, there is no consensus on whether the use of titanium plates will hinder the development of the mandible. This study shows that titanium plates do indeed limit the growth of the mandible.

Methods: A 4-year-old boy with a comminuted mandibular fracture underwent open reduction and internal fixation surgery. The displaced lingual bone blocks were reduced and fixed. The patient had bilateral submandibular fistulas and local titanium plate exposure in the mandibular vestibular groove for up to 3 months. The titanium plates were removed 3 months after surgery. A large area of bone defect was observed on the labial side of the mandible, which was previously covered by the titanium plates, with uneven cortical bone. After removing the titanium plates, the wounds gradually healed. During the 2-year follow-up, it was observed that the mandibular morphology had recovered well, and the cortical bone was smooth.

Results: After the restriction of the titanium plates was lifted, the growth of the mandible was rapidly restored.

Conclusion: The presence of titanium plates affects wound healing and limits the growth of the mandible. Metal internal fixation materials need to be removed in a timely manner to avoid hindering the growth and development of the jawbone.