Al Haitham Al Shetawi1, C Anthoney Lim2, Yash K Singh3, Jason E Portnof4, Stephen M Blumberg2. 1. Former Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Otolaryngology, Mount Sinai Beth Israel, New York, NY. Electronic address: halshetawi@gmail.com. 2. Assistant Professor of Pediatrics, Pediatric Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY. 3. Private Practice, Midwest Oral and Maxillofacial Surgery, Fort Wayne, IN. 4. Associate Clinical Professor, Department of Oral and Maxillofacial Surgery, Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, FL.
Abstract
PURPOSE: To review the epidemiology and management of facial fractures in a pediatric population. MATERIALS AND METHODS: This study was a retrospective review of patients younger than 18 years who presented to a pediatric emergency department during a 5-year period in an urban, academic, level 1 designated trauma center. RESULTS: Of the 156 patients identified, most were boys (87%) and the mean age was 13.5 years (standard deviation, 4.9 yr; interquartile range, 12 to 17 yr). The most common mechanism of injury 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 panfacial (P = .005), frontal (P = .001), and orbital (P = .04) fractures. Most patients (91.7%) were admitted, and nonoperative repair was undertaken in 57.1%. There was an independent association of surgical intervention with age older than 14 years and with mandibular fractures (P < .01). CONCLUSIONS: Assault was the most common mechanism of injury and mandibular fracture was the most commonly encountered. Concomitant nonfacial injuries occurred in most patients. Patients sustaining panfacial, frontal, and orbital fractures should provoke an evaluation for other intracranial injuries. Children older than 14 years and those with mandibular fractures should prompt mobilization of resources for operative repair.
PURPOSE: To review the epidemiology and management of facial fractures in a pediatric population. MATERIALS AND METHODS: This study was a retrospective review of patients younger than 18 years who presented to a pediatric emergency department during a 5-year period in an urban, academic, level 1 designated trauma center. RESULTS: Of the 156 patients identified, most were boys (87%) and the mean age was 13.5 years (standard deviation, 4.9 yr; interquartile range, 12 to 17 yr). The most common mechanism of injury 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 panfacial (P = .005), frontal (P = .001), and orbital (P = .04) fractures. Most patients (91.7%) were admitted, and nonoperative repair was undertaken in 57.1%. There was an independent association of surgical intervention with age older than 14 years and with mandibular fractures (P < .01). CONCLUSIONS: Assault was the most common mechanism of injury and mandibular fracture was the most commonly encountered. Concomitant nonfacial injuries occurred in most patients. Patients sustaining panfacial, frontal, and orbital fractures should provoke an evaluation for other intracranial injuries. Children older than 14 years and those with mandibular fractures should prompt mobilization of resources for operative repair.
Authors: Dong Jin Yang; Youn-Jung Kim; Dong-Woo Seo; Hyung-Joo Lee; In-June Park; Chang Hwan Sohn; Jung Min Ryoo; Jong Seung Lee; Won Young Kim; Kyoung Soo Lim Journal: Clin Exp Emerg Med Date: 2017-03-30