Pediatric Facial Fractures: Demographics, Injury Patterns, and Associated Injuries in 3334 Patients

Area of Science:

• Pediatric Traumatology
• Craniofacial Surgery
• Pediatric Emergency Medicine

Background:

• Pediatric craniofacial fractures present unique injury patterns and growth implications distinct from adult fractures.
• Existing research often focuses on specific patient subgroups (inpatients, operative cases) or specialties.
• A comprehensive institutional assessment is needed to understand the full spectrum of pediatric facial fractures.

Purpose of the Study:

• To comprehensively characterize pediatric craniofacial fractures.
• To analyze injury patterns, etiology, and management in relation to patient age.
• To establish a framework for future outcome and prevention studies.

Main Methods:

• Retrospective review of 3,034 patients under 18 years old evaluated for facial fractures.
• Data collected from 2006-2021 at a Level I pediatric trauma center.
• Subanalysis performed based on age groups, examining demographics, etiology, fracture patterns, associated injuries, management, and outcomes.

Main Results:

• Mean age was 11.5 ± 4.9 years; 68.4% were male, 82.6% Caucasian.
• Sports led injuries in older children (>12 years), while daily activities predominated in younger children (<6 years).
• Hospitalization occurred in 32%, ICU care in 6%, and surgery in 48.4%. ICU admission decreased with age (P<0.001), while operative intervention increased (P<0.001). Older patients had more zygomaticomaxillary complex and nasal fractures, while younger patients had more skull and orbital fractures.

Conclusions:

• This study provides an updated, comprehensive characterization of pediatric craniofacial fractures across a large cohort.
• Age-specific differences in injury etiology, fracture patterns, and management requirements were identified.
• Findings offer a crucial foundation for targeted preventative strategies and future research on pediatric facial fracture outcomes.