Physical Therapy as first therapy to mandibular fracture in a pediatric patient

Mandibular fractures are the most common in children, however with a low incidence because of child anatomy. Among the sites, the condyle is one the most fracture site, being a dilemma to surgeons about your management. The treatment to condyle fracture can be a surgical approach or conservative management. Conservative treatment presents the IMF, appliances, soft diet, and physiotherapy as an option, and these treatments can be applied isolated or associated. Physical Therapy has been a few reported in the literature as isolated therapy, reported as complementing the surgical approach, or after orthodontic/appliances therapy. Promote early mandibular mobility is important to restore function and prevent future complications such as ankylosis. Instruments to perform physiotherapy are expensive and not accessible to the entire population. Therefore, the present study presents a case of a pediatric patient with condyle fracture treated with a soft diet and physiotherapy with wooden spatula.

Case Report: Unusual Presentation of Myositis Ossificans of the Elbow in a Child Who Underwent Excessive Postoperative Rehabilitation Exercise

Traumatic myositis ossificans (MO) is an unusual complication after muscle injury and is predominantly seen in young adults and adolescents. Pediatric MO cases are even rarer. We report an 8-year-old girl who was diagnosed with a lateral humeral condyle fracture. She was treated surgically, and her elbow joint was fixed with plaster. Rehabilitation exercise was administered 1 month after the operation. Due to the wrong exercise method, a palpable bony mass appeared around the elbow 1 month later. The clinical radiological diagnosis showed MO, and conservative treatment was administered. After 3 years of follow-up, the affected limb functioned well, with no sign of recurrence. Here, we report this long-term follow-up case of MO resulting from excessive rehabilitation exercise.

Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children

Background Humeral lateral condyle fractures (HLCFs) are common paediatric fractures. Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs. Methods 60 children who should be suspected to be HLCFs in clinical practice from Dec 2015 to Nov 2017 were continuously included as the first part patients. Subsequently, 35 HLCFs patients with complete follow-up information who had no obvious displacement on radiograph were the second part patients. The sensitivity and specificity of radiograph and MRI in diagnosing of HLCFs and their stability were calculated respectively. Calculated the sensitivity and specificity of each scan sequence of MRI in diagnosing of HLCFs osteochondral fractures. The degree of fracture displacement was measured respectively. Compared the ratio of surgical treatment, secondary fracture displacement and complications between the stable fracture group and the unstable fracture group on MRI in part 2 patients. Results Sensitivity of diagnosing HLCFs by MRI was significantly higher than radiograph (100.00% vs. 89.09%, P = 0.03). Sensitivity of diagnosing integrity of trochlear cartilage chain by MRI was 96.30%, which was significantly higher than that by radiograph (62.96%, P < 0.01). The sensitivity of cartilage sensitive sequence (3D-FS-FSPGR/3D-FSPGR) was different with FS-PDWI and FS-T2WI (P = 0.01 and P = 0.02, respectively). The degree of HLCFs displacement by MRI was higher than radiograph (P < 0.05). In the unstable fracture group, 5 cases (45.45%) had a fracture displacement of more than 2 mm on MRI, which was significantly higher than that in stable fracture group (0.00%, P < 0.01). Conclusions MRI is superior to the radiograph of elbow joint in evaluating and diagnosing children HLCFs and their stability. The coronal 3D-FS-FSPGR/3D-FSPGR sequence is a significant sequence for diagnosing osteochondral fractures in HLCFs. MRI can provide important clinical value for treatment decisions of HLCFs without significant displacement.

Clinical examination of various jaw fractures and evaluation of open and closed reductions: Six case reports

Aim: This study aims to present the fracture types and treatment methods of jaw fracture cases that presented at our center. Methodology: Of six presenting cases, two were angulus, one was parasymphysis, three were subcondylar, and one was a medial condyle fracture only. All patients were evaluated both clinically and radiologically by CT of the atlanto-occipital joint. We managed two of the mandibular fractures with open and closed reduction (mixed) and four with closed reduction only. Dislocation was observed in only two patients. Internal fixation was performed using either mini plates (Medartis, Basel, Switzerland) or mini-screws. All cases united within three weeks to three months. Results: After analyzing the epidemiology of six fractures and the outcomes of the surgical treatment, as well as assessing the complications related to the surgical procedures, it was determined that in cases with dislocation, bimaxillary fixation should be applied as a maintenance to open reduction therapy. In cases without dislocation, bimaxillary fixation only is sufficient. Conclusion: An analysis of dislocation conditions according to fracture type supports that the incidence of dislocation is low in condyle fractures. Conclusion: An analysis of dislocation conditions according to fracture type supports that the incidence of dislocation is low in condyle fractures. How to cite this article: Özüdoğru S, Başaran MM, Ataözden T. Clinical examination of various jaw fractures and evaluation of open and closed reductions: Six case reports. Int Dent Res 2021;11(Suppl.1):274-8. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.40 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

REHABILITATION OF A 60-YEAR-OLD WOMAN’S TIBIAL PLATEAU FRACTURE

Tibial plateau fracture is one of the commonest fractures which leads to the break in the continuity of the upper part of the tibia (shinbone) that involves the knee joint. It involves either lateral tibial condyle or medial tibial condyle or both. This fracture interferes with the normal functioning of the body in day-to-day life. Therefore, physiotherapy rehabilitation after surgery is essential to get back to normal functioning. A 60-year-old female who slipped from a two-wheeler started experiencing severe pain & swelling around the knee joint. Her relatives brought her to Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, Maharashtra. X-ray was done and she was diagnosed with lateral tibial condyle fracture (tibial plateau fracture) and then underwent open reduction internal fixation with plate osteosynthesis. Later, she was referred for physiotherapy rehabilitation, which aimed to restore mobility, regain full range of motion, develop muscle strength and build up to weight-bearing. The tibial plateau fracture is a form of fracture with a low occurrence and is a complicated fracture to treat.The above case study concludes that a traditional surgical procedure combined with timely planned physiotherapy rehabilitation contributed to progressive improvement in functional goals, which is an important factor in achieving a good recovery in such post-operative cases.