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Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e318230c8cf
Pediatric/Craniofacial: Original Articles

Pediatric Facial Fractures: Demographics, Injury Patterns, and Associated Injuries in 772 Consecutive Patients

Grunwaldt, Lorelei M.D.; Smith, Darren M. M.D.; Zuckerbraun, Noel S. M.D.; Naran, Sanjay M.D.; Rottgers, S. Alex M.D.; Bykowski, Michael B.S.; Kinsella, Christopher M.D.; Cray, James Ph.D.; Vecchione, Lisa D.M.D., M.D.S.; Saladino, Richard A. M.D.; Losee, Joseph E. M.D.

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Abstract

Background: Pediatric craniofacial fractures are anatomically distinct from their adult counterparts and must be managed with respect for future growth and development. These injuries must be approached as entities fundamentally different from adult craniofacial fractures. Here, the authors aim to provide context for practitioners managing pediatric facial fractures by augmenting presently available demographic, diagnostic, and treatment data.

Methods: This is a retrospective review of demographics, diagnosis, and treatment of patients under 18 years of age presenting to the emergency department of a pediatric level I trauma center between 2000 and 2005 with facial fractures. Patients were included regardless of treating specialty, treatment modality, or inpatient status.

Results: A total of 772 consecutive patients met inclusion criteria. A significant majority (p < 0.001) of patients (68.9 percent) were male; older children were significantly more likely to sustain a facial fracture (p < 0.001). Fracture pattern, level of care, and cause of injury varied by age; 55.6 percent of patients had severe associated injuries. Male subjects, older patients, and patients of lower socioeconomic status were significantly more likely to sustain facial fractures secondary to violence (p ≤ 0.001).

Conclusions: Pediatric facial fractures may be associated with severe concomitant injuries. Injury patterns are significantly correlated with socioeconomic metrics.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.

©2011American Society of Plastic Surgeons

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