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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.

Plastic and Reconstructive Surgery: December 2011 - Volume 128 - Issue 6 - p 1263–1271
doi: 10.1097/PRS.0b013e318230c8cf
Pediatric/Craniofacial: Original Articles
Press Release

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.


Pittsburgh, Pa.

From the Division of Pediatric Plastic Surgery and the Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center.

Received for publication May 5, 2011; accepted June 15, 2011.

Dr. Grunwaldt and Dr. Smith should be considered co–first authors.

Disclosure: The authors have no financial information to disclose.

Joseph E. Losee, M.D.; One Children's Hospital Drive, 4401 Penn Avenue, Faculty Pavilion, 7th Floor, Suite 7104, Pittsburgh, Pa. 15224,

©2011American Society of Plastic Surgeons