Pediatric maxillofacial injuries - if a new look is required?

Maxillofacial injuries in children always present a challenge in respect of their diagnosis and management. The phenomenal increase in automotives on the road has led to a tremendous rise in the number of road traffic accidents leading to facial injuries, of which children are the most unfortunate victims. The purpose of this retrospective study was to evaluate the epidemiology, etiology and pattern of facial injuries and also to access the most feasible method for the management of facial injuries in children without hampering the facial growth.

The records and radiographs of 110 patients within the age range of 0-16 years were retrospectively reviewed who have presented with maxillofacial injuries to our department from October 2008 to June 2012. The information extracted from patient's case records included patient's gender (male/female), age, etiology, fracture type (single fractures and multiple fractures), occlusal status, fracture site and treatment performed.

Patient's age at the time of accident ranged from 0 to 16 years, with a mean of 6.1 years. 54.54% (n = 60) of the patients were under 6 years (infants and preschool), 31.82% (n = 35) were between 6 and 11 (school age), and 13.64% (n = 15) were between 12 and 16 years (adolescents). Road side accident was the most frequent cause of injury. Most fractures occurred in the mandible (54.54%; n = 60). The fractures with minimal or no occlusal disturbance were managed by liquid diet alone.

We believe that even after so much advancement in surgical techniques and armamentarium, conservative treatment is still the most reliable approach in managing maxillofacial injuries in children.