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Nonfatal Sport-Related Craniofacial Fractures: Characteristics, Mechanisms, and Demographic Data in the Pediatric Population

MacIsaac, Zoe M. M.D.; Berhane, Hebist B.S.; Cray, James Jr. Ph.D.; Zuckerbraun, Noel S. M.D.; Losee, Joseph E. M.D.; Grunwaldt, Lorelei J. M.D.

Plastic and Reconstructive Surgery: June 2013 - Volume 131 - Issue 6 - p 1339–1347
doi: 10.1097/PRS.0b013e31828bd191
Pediatric/Craniofacial: Original Articles
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Background: Few reports exist on sport-related craniofacial fracture injuries in the pediatric population. Most patients with craniofacial injuries are adults, and most studies on pediatric sport injuries do not focus specifically on craniofacial fractures. The authors’ goal was to provide a retrospective, descriptive review of the common mechanisms of sport-related craniofacial injuries in the pediatric population, identifying the characteristics of these injuries and providing a description of the demographics of this population.

Methods: The study population included children between the ages of 0 and 18 years who were seen in the emergency department at Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center between 2000 and 2005. Of the 1508 patients identified, 167 had injuries caused by sport-related trauma (10.6 percent).

Results: After evaluation in the emergency department, 45.5 percent were hospitalized, and 15.0 percent of these were admitted to the intensive care unit. The peak incidence of sport-related injuries occurred between the ages of 13 and 15 years (40.7 percent). Nasal (35.9 percent), orbital (33.5 percent), and skull fractures (30.5 percent) were most common, whereas fractures of the maxilla (12.6 percent), mandible (7.2 percent), zygomaticomaxillary complex (4.2 percent), and naso-orbitoethmoid complex (1.2 percent) were observed less frequently. Baseball and softball were most frequently associated with the craniofacial injuries (44.3 percent), whereas basketball (7.2 percent) and football (3.0 percent) were associated with fewer injuries. The most common mechanisms of injury were throwing, catching, or hitting a ball (34.1 percent) and collision with other players (24.5 percent).

Conclusion: These data may allow targeted or sport-specific craniofacial fracture injury prevention strategies.

Pittsburgh, Pa.; and Augusta, Ga.

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; University of Pittsburgh School of Medicine; and the Departments of Oral Biology and Surgery/Plastic Surgery, Georgia Health Sciences University.

Received for publication November 5, 2012; accepted December 5, 2012.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Lorelei J. Grunwaldt, M.D., Division of Pediatric Plastic Surgery, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, One Children’s Hospital Drive, 4401 Penn Avenue, Faculty Pavilion, 7th Floor, Suite 710, Pittsburgh, Pa. 15224,

©2013American Society of Plastic Surgeons