Purpose: Among the variable forms of craniosynostosis, sagittal synostosis represents the most common type of nonsyndromic single-suture fusion. There are many variations of this form that have been recognized in the literature. We aim to identify and categorize the clinical and radiological characteristics for patients with sagittal synostosis from 2014 to 2017. Secondly, to define a classification system wherein quantitative and qualitative descriptors are used to provide a better understanding of the disease process.Methodology: An institutional retrospective analysis identified all patients during the 2014 to 2017 period with computer tomography (CT) diagnosed single suture sagittal craniosynostosis (n ¼ 51). Redo cases were excluded from the study. The data was collected from CT radiological evidence, clinical images, and medical notes. The patients were stratified into clinical assessment, radiological and neurological, and a statistical analysis was performed. Results: The average age for CT scans was 3 months and operative management 6.4 months, respectively. The most common presentation:Complete synostosis of anterior, central, and posterior (n ¼ 31).Frontal and interhemispheric subarachnoid space (n ¼ 23). Clinical appearance of sagittal ridge, occipital bullet, and frontal (n ¼ 13) and occipital and frontal (n ¼ 13).Conclusions: Sagittal synostosis presented with many heterogeneous variations. The classic appearance of a sagittal ridge, occipital bullet and/or frontal bossing, with frontal interhemispheric and subarachnoid spaces, and complete sagittal fusion was most common. A holistic classification can aid in the assessment and prioritization of surgical intervention. Future longitudinal studies would provide additional insight into the relationships between clinical appearance and suture fusion.
Introduction: Facial fractures of children are relatively infrequent compared to adults. There are variations in facial fractures depending on the socioeconomic, cultural, and educational factors of the country and time. Our aim is to describe epidemiological trends of facial fractures in the pediatric population, understand differences amongst the age groups, and the impact this has on clinical outcomes and management in South Australia. Methods: A retrospective review was conducted from January 2012 to January 2017 at the Women and Children's Hosptial, Adelaide. All facial fractures of children, aged 16 years and below, that attended or were referred to the unit were included in this study. Results: A total of 265 pediatric patients presented with a facial fracture with a male predominance. Some 49.1% occurred from a sports-related injury with bicycle motocross as the single most common type of sport. The mandible was the common fracture type with 21.9% of the total cohort having an associated injury. There were significant differences between boys and girls for age, age groups, mechanism of injury, and type of sport (P < 0.05). Boys were 2.3 times more likely to have a sport-related facial fracture than girls. Early adolescence were 5.2 times more likely to have an orbitozygomatic fracture than children of early childhood (P < 0.05). Age, associated injuries, and sportrelated facial fractures were independently associated with increased length of stay (P < 0.001). Conclusions: There are differences amongst boys and girls and an understanding of these differences can aid the diagnosis and management in a growing child's face.
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