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Review
. 2021 Jan 1;13(1):e67-e74.
doi: 10.4317/jced.57323. eCollection 2021 Jan.

Closed versus open reduction of facial fractures in children and adolescents: A systematic review and meta-analysis

Igor Pereira  1 , Eduardo Pellizzer  1 , Cleidiel Lemos  1 , Sandra Moraes  1 , Belmiro Vasconcelos  1
Affiliations
Review

Closed versus open reduction of facial fractures in children and adolescents: A systematic review and meta-analysis

Igor Pereira et al. J Clin Exp Dent. .

Abstract

Background: Treatment of facial fractures in children and adolescents has always been a challenge for oral surgeon. The choice of treatment type must take into account several factors. This systematic review aimed to evaluate closed versus open reduction of facial fractures for pediatric facial fractures.

Material and methods: A systematic review of the literature was conducted in three databases (PubMed/MEDLINE, Embase and The Cochrane Library) in accordance with the PRISMA statement. The PICO question was: Conservative treatment is more appropriate than surgical treatment for reducing facial fractures in children and adolescents? The full papers of 41 references were analyzed in detail. Eleven papers were included in this systematic review: one prospective study and ten retrospective studies. All studies evaluated the complication rate.

Results: A total of 73 (7.68%) of the 950 patients experienced complications. Among these patients, 24 (3.85%) had been treated with conservative treatment and 49 (15.03%) with surgical treatment. The fixed-effects model revealed a lower complication rate with conservative treatment than surgical treatment (P<0.00001; RR: 0.18; 95% CI: 0.11-0.28). Heterogeneity was low for the complication rate outcome (X2: 5.64; P = 0.69; I2: 0%).

Conclusions: The present findings show that conservative treatment is more commonly performed for pediatric facial fractures and complications occur more with surgical treatment. Therefore, surgeons must evaluate all variables involved in choosing the most appropriate treatment method to ensure greater benefits to the patient with fewer complications. Key words:Closed fracture reduction, open fracture reduction, pediatrics, treatment failure.

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Conflict of interest statement

Conflicts of interest We have no conflicts of interest.

Figures

Figure 1
Figure 1
QUORUM flow diagram of the article selection process.
Figure 2
Figure 2
Forest plot of heterogeneity for type of treatment and complications rate outcome.
Figure 3
Figure 3
Funnel with symmetry of included studies for complications rate.
See this image and copyright information in PMC

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