Motor vehicle crashes, violence are leading causes of facial fractures in children

Facial fractures in pediatric patients occur in different patterns in different age groups — but most often occur with other types of severe injuries, according to a recently published study from researchers at the Children’s Hospital of Pittsburgh.

The findings, published in Plastic and Reconstructive Surgery, lends new insights into trends in the demographics, diagnosis and treatment of pediatric facial fractures — including higher rates of fractures caused by violence among adolescents, low-income and minority youth.

According to a news release from the American Society of Plastic Surgeons, the researchers analyzed 772 cases of facial fracture in infants, children and adolescents over a 5-year period, focusing on differences in patient characteristics, fracture patterns and treatment in three age groups: 0 years to 5 years, 6 years to 11 years and 12 years to 18 years. Children who suffered skull fractures only — without a fracture of facial bones — were excluded from the study.

Sixty-nine percent of the patients in the study were boys, according to the release, with the average age of the whole cohort being 10.7 years. Throughout all age groups, orbital fractures were the most common. Jaw, nasal and other fracture types increased with age, the researchers found, with infants and young children being more likely to require treatment in the intensive care unit and older children being more likely to need surgery.

The researchers, according to the release, found motor vehicle crashes to be the most common cause (21%) of facial fractures. However, causes were varied across age groups. Infants and children up to the age of 5 years accounted for 20% of facial fractures, with falls being the most likely cause and none being injured due to violence. Children 6 years to 11 years of age accounted for 33% of facial fractures, the release noted, with motor vehicle crashes being the most common cause, followed by play and bicycle riding.

The largest group in the cohort was the adolescent group of children 12 years to 18 years of age, accounting for 47% of fractures in the study. Violence was the most common cause of facial fractures in these patients, followed by sports-related injuries. Across all age groups, the researchers found 56% of children had other types of traumatic injuries — including a 22% rate of concussions. Overall, 63% of the children were hospitalized and 1.4% died.

Reference:

Gunwaldt L, Smith DM, Zuckerbraun NS, et al. Pediatric facial fractures: Demographics, injury patterns, and associated injuries in 772 consecutive patients. Plast Reconstr Surg. 2011. doi: 10.1097/PRS.0b013e318230c8cf

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