Pediatric Panfacial Fractures
Sameer Shakir1, Russell E Ettinger2, Srinivas M Susarla2
1Division of Plastic Surgery, Children's Wisconsin, Milwaukee, WI, USA.
Insights
Pediatric panfacial trauma requires specialized management due to unique growth factors in children. This review details an institutional approach considering anatomy, epidemiology, and surgical techniques for these rare injuries.
Area of Science:
- Craniofacial surgery
- Pediatric trauma
- Maxillofacial reconstruction
Background:
- Pediatric panfacial trauma is uncommon, with limited understanding of its effects on child development.
- Current treatment often adapts adult protocols, but requires modifications for pediatric patients.
- Children possess enhanced healing and remodeling potential, influencing management decisions.
Purpose of the Study:
- To review an institutional philosophy for managing pediatric panfacial trauma.
- To highlight key considerations including anatomy, epidemiology, and examination.
- To discuss sequencing of care and postoperative management specific to pediatric patients.
Main Methods:
- Review of institutional management protocols for pediatric panfacial trauma.
- Analysis of anatomic, epidemiologic, and clinical factors.
- Consideration of growth center preservation and specialized fixation techniques.
Main Results:
- Treatment emphasizes nonoperative approaches when feasible due to augmented healing.
- Minimizing surgical exposure is crucial to protect growth centers.
- Creative fixation strategies are necessary for the immature craniofacial skeleton.
Conclusions:
- Management of pediatric panfacial trauma necessitates a tailored approach distinct from adult protocols.
- Preservation of growth centers and utilization of the child's healing capacity are paramount.
- A comprehensive understanding of pediatric craniofacial anatomy and injury patterns guides effective treatment.
Abstract:
Pediatric panfacial trauma is a rare occurrence with poorly understood implications for the growing child. Treatment algorithms largely mirror adult panfacial protocols with notable exceptions including augmented healing and remodeling capacities that favor nonoperative management, limited exposure to avoid disruption of osseous suture and synchondroses growth centers, and creative fracture fixation techniques in the setting of an immature craniomaxillofacial skeleton. The following article provides a review of our institutional philosophy in the management of these challenges injuries with important anatomic, epidemiologic, examination, sequencing, and postoperative considerations.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:08Overview of the Skull
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...