Factors Associated With Surgical Management for Pediatric Facial Fractures at a Level One Trauma Center
Joseph K Moffitt1, D'Arcy J Wainwright1, Marisa Bartz-Kurycki2
1Division of Pediatric Plastic Surgery.
The Journal of Craniofacial Surgery
|May 4, 2019
Summary
Pediatric facial fractures are common, with orbit fractures being most frequent. Older children with mandible or Le Fort fractures are more likely to need surgery, unlike those with traumatic brain injury.
Area of Science:
- Pediatric Traumatology
- Craniofacial Surgery
- Emergency Medicine
Background:
- Pediatric facial fractures differ in presentation and management from adults.
- Understanding patterns and predictors of surgical need is crucial for optimal care.
Purpose of the Study:
- To describe the pattern and mechanism of pediatric facial fractures.
- To identify factors associated with the need for surgical management in children.
Main Methods:
- Retrospective chart analysis of pediatric patients (≤18 years) with facial fractures over 10 years.
- Review of demographics, fracture location, injury mechanism, and surgical treatment.
- Statistical analysis comparing surgical and non-surgical cohorts.
Main Results:
- 1,274 pediatric patients with 2,172 facial fractures were analyzed.
- Orbit fractures were most common (29% of fractures, 49% of patients).
- Increased age, mandible fractures, and Le Fort fractures correlated with higher odds of surgical management. Traumatic brain injury correlated with reduced odds of surgery.
Conclusions:
- Older pediatric patients, particularly those with mandible or Le Fort fractures, have increased odds of requiring surgical intervention.
- Concomitant traumatic brain injury may defer surgical repair of facial fractures due to the severity of other injuries.
- Data can inform improved patient education, counseling, and predictive models for pediatric facial fractures.
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