The Importance of Early Recognition of Condylar Fractures in Children: A Study of 2 Cases

Maxillofacial fractures in general and mandibular fractures in par-ticular seem to be less common in children than in adults; how-ever, this finding might be influenced by the fact that condylar fractures in children are often undiagnosed and so the true inci-dence is likely to be higher than that reported in literature. Traumatic lesions of the temporomandibular joint often are over-looked as they can apparently occur with relatively little pain, few clinical signs, and insufficient reaction by the child to alert an adult to the seriousness of the injury. Only 1 to 2 years later, when growth disturbances appear, are they perceived as a prob-lem, but by that time, the dysplastic growth pattern has stabilized and will continue over a period of years. The problem is fre-quently underestimated because of the difficulties inherent in pedi-atric pain assessment. The fact that the mechanisms of pain per-ception in children differ somewhat from adult pain perception mechanisms is one factor that can make pediatric pain assessment difficult. This paper outlines 2 case reports that draw attention to pain in children in the case of temporomandibular joint injury. The inability to assess pain adequately may lead to a delay in diag-nosis and treatment and possibly result in future growth distur-bances and facial asymmetries.

children; pain assessment; pain perception; pain sensitivity; temporomandibular joint fractures

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