Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study

Abstract

Background/Aims Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period. Methods The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001). Conclusion The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.

Pediatric mandibular fractures: Surgical management and outcomes in the deciduous, mixed and permanent dentitions

“…As reported in many studies, [3][4][5]7 the mandible is the most frequent site of maxillofacial injury in the paediatric population. Males are principally affected and road traffic accidents are the major cause.…”

“…Mandibular fractures are among the most frequent injuries of the maxillofacial region not only in adults, but also in children and adolescents, with incidences ranging from 20% to 50%. [1][2][3][4][5] Management can be challenging given the anatomical and behavioural differences between children and adults, such as the small bone size, the vulnerabilities of the deciduous and mixed dentitions, bone elasticity, accelerated healing, and the poor compliance of paediatric patients. [6][7][8][9] Although open reduction and internal fixation (ORIF) is the therapeutic gold standard for adults, 10 the treatment for paediatric mandibular fractures remains controversial.…”

The Etiology and Epidemiology of Pediatric Facial Fractures in North-Western Romania: A 10-Year Retrospective Study

“…The pediatric patients were distributed in three distinct age groups, respectively 0–6 years, 7–12 years and 13–18 years. This distribution was preferred because it comprises three important periods in the development of pediatric patients, namely preschool, school and adolescence [ 23 ], but also because it was used in other similar studies [ 20 , 23 ]. The incidence of pediatric facial fractures was influenced by these investigated variables.…”

Mapping Evidence on the Epidemiology and Cost Associated with Maxillofacial Injury among Adults in Sub-Saharan Africa: A Scoping Review Protocol

“…Maxillofacial injury (MI) is categorized as a nature of injury [ 6 ] and is characterized by the injury that may result in damage to soft and hard tissues of the facial region in the form of burns, lacerations, and fractures [ 7 , 8 ]. The fractures that entail the orbits, maxillary, nasal, mandible, and other bones in the facial region [ 9 , 10 , 11 ]. The incidence of fracture of the facial bones in 2019 was estimated at 7.5 million, with 1.8 million persons existing with the disability and this resulted in 117,402 years lived with a disability (YLDs) [ 6 ].…”