FEATURES OF FIXING MINI-PLATES FOR FRACTURES OF THE LOWER JAW ANGLE IN CHILDREN

Abstract

Most often, fractures of the maxillofacial region in children occur in the periods of 6-7 years-the time of the beginning of school attendance, 12-14 years – a significant increase in physical activity, participation in sports competitions and training, 16-18 years – hooligan injuries. It is known that in the treatment of fractures of the lower jaw, orthopedic and surgical methods are more often used, namely splinting the double jaw with rubber rods. In modern maxillofacial surgery, titanium plates and screws for osteosynthesis are widely used to fix bone fragments in fractures of various localization, which makes it possible to ensure reliable retention of fragments in three planes for the entire period of fracture consolidation. Purpose of the work. Improving the effectiveness of treatment of fractures of the lower jaw angle in children aged 6-8 years by determining the optimal place for fixing mini-plates using the analysis of computer tomograms. Materials and methods of research. We analyzed the medical records of children with fractures of the lower jaw corners who were treated by osteosynthesis in the maxillofacial departments of Dnipro city hospitals for the period from 2012 to 2020. In order to determine safe areas for fixing mini-plates in fractures of the lower jaw angle, we analyzed 23 CT scans in children aged 6-8 years. Research results and their discussion. Our analysis of 23 tomograms of children aged 6-8 years revealed the closest possible location of the mandibular canal in 100% of cases. Taking into account the anatomical features of the structure of the lower jaw and the presence of rudiments of permanent teeth in children of the studied age, generally accepted drilling along the lower edge of the jaw from the distal edge of the permanent canine to the distal edge of the second permanent molar is risky. In addition, we took into account that the strength of the masticatory muscles in children is significantly less than in adults, so it is sufficient to use only one mini-plate for fractures of the lower jaw angle. One of the main stages of successful treatment of fractures of the lower jaw angle in children aged 6-8 years by osteosynthesis is the justification of the location of screws for fixing mini-plates. Conclusions. Based on the data obtained in the study of orthopantomograms and computer tomograms, we identified safe drilling points for fixing the mini-plate during the treatment of fractures of the lower jaw angle by osteosynthesis in children aged 6-8 years. In addition, certain drilling points for screws can be used in the development of a surgical template positioned on the teeth.