A 2-year-old boy presented with a symphyseal mandibular fracture (Guardman’s fracture) following a fall from bed. Clinical examination revealed chin swelling, mobility of the lower incisors, and deranged occlusion. Radiographic evaluation confirmed a non-displaced fracture line extending through the mandibular symphysis between developing tooth buds. Considering the patient’s age and limited cooperation, closed reduction under general anesthesia was performed using a prefabricated acrylic cap splint stabilized with circummandibular wiring. Postoperative management included antibiotics, analgesics, and a soft diet. The splint and wires were removed after three weeks. Follow-up at three months demonstrated complete bony healing, restoration of normal occlusion, and preservation of developing dentition. This case highlights cap splint fixation under general anesthesia as a safe, conservative, and effective treatment modality for managing mandibular symphyseal fractures in very young children while protecting mandibular growth centers.
Sharma et al. (Tue,) studied this question.
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