Pediatric Maxillofacial Trauma: a Review of 156 Patients

Publication date: Available online 12 March 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Al Haitham Al Shetawi, C. Anthoney Lim, Yash K. Singh, Jason E. Portnof, Stephen M. Blumberg
PurposeTo review the epidemiology and management of facial fractures in a pediatric population.Materials and MethodsRetrospective review of patients under 18 years old presenting to a pediatric emergency department over a 5-year period in an urban, academic, Level-1 designated trauma center.Results156 patients were identified. Most were male (87%), and the mean age was 13.5 years (SD+/-4.9, IQR 12-17). The most common mechanism of injury (MOI) was assault (48.1%). Mandibular fractures (40.7%) were most common. Multiple fractures occurred in 26.9% of patients. Concomitant injuries occurred in 73.7% of patients, most commonly concussions (39.1%). Intracranial hemorrhages were associated with pan-facial (p=0.005), frontal (p=0.001), and orbital fractures (p=0.04). Most patients (91.7%) were admitted, and non-operative repair was undertaken in 57.1%. There was an independent association between surgical intervention and age >14 years and mandibular fractures (p<0.01).ConclusionsAssault was the most common MOI and mandibular fracture was the most commonly encountered. Concomitant non-facial injuries occurred in a majority of patients. Patients sustaining pan-facial, frontal, and orbital fractures should provoke evaluation for other intracranial injuries. Children >14 years old and those with mandibular fractures may prompt mobilization of resources for operative repair.



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