Pediatric Craniofacial Fractures

Naran, Sanjay; MacIsaac, Zoe M.; Katzel, Evan B.; Bykowski, Michael R.; Shakir, Sameer; Goldstein, Jesse A.; Pollack, Ian M.; Losee, Joseph E.

doi:10.1097/scs.0000000000002837

Cited by 20 publications

(21 citation statements)

References 13 publications

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“…While younger children generally suffer from trauma due to lowintensity forces, such as falls, older children are more likely to be exposed to highintensity forces, such as those resulting from traffic accidents, be cause as they grow, their trauma profile becomes similar to that observed in adults. 4,7 In addition, when they are young, children are protected by their parents against harmful events. 3 Regarding the time and day of the week of traffic acci dents, the concentration of events in the evening and on weekends corroborates other findings.…”

Section: Discussionmentioning

confidence: 99%

“…241 million individuals in 2016, and studies have shown that these ac cidents represent the main etiology of craniofacial trauma among children. 3,4 The consequences of trauma in the craniofacial region can include any combination of bone, soft tissue or dental injury. 5 The location and pattern of the injury depend on the interrelation between the etiology of the injury and the magnitude of the impact as well as on the character istics of the victim's developmental stage.…”

Section: Introductionmentioning

confidence: 99%

“…7 A mechanism of injury involving greater impact, such as a traffic accident, is required for this trauma to occur. 4 Due to differences in anatomical development, craniofa cial trauma can be considered uncommon in children when compared to adults, 8 but facial injuries to soft tissues occur more frequently in children. 7,9 Studies indicate that there is a general increase with age in the incidence of facial trauma and a decrease in the incidence of head trauma.…”

Section: Introductionmentioning

confidence: 99%

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Craniofacial trauma in Brazilian child victims of traffic accidents: A single-trauma center analysis

Laureano¹,

Palitot²,

Cavalcanti³

et al. 2021

Dent. Med. Probl.

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Background. Road traffic accidents are a significant public health problem and a major cause of economic loss globally.Objectives. The aim of the study was to describe the epidemiological profile of child victims of traffic accidents and the prevalence of craniofacial trauma in a municipality in the northeastern region of Brazil. Material and methods.A documentary study was carried out through the analysis of the medical records of the traffic accident victims hospitalized in emergency wards in the municipality of Campina Grande, Paraíba, Brazil, from January to December 2016. A total of 1,884 medical records were evaluated, among which 85 (4.5%) referred to children aged 0-12 years. The information related to the sociodemographic profile of the victims, traffic accidents and clinical variables was collected. The data was analyzed using descriptive and inferential statistics, and a 5% level of significance was adopted.Results. The victims were predominantly males (64.7%) and 9-12-year-old children (43.5%). Most accidents were recorded in the evening (48.2%) and on the weekend (32.9%). Among the victims, 37.6% were involved in motorcycle accidents. Craniofacial injuries were found in 44.7% of the children. Most victims were not admitted to the intensive care unit (ICU) (80.0%). Craniofacial trauma was significantly associated with motorcycle (p = 0.043) and automobile accidents (p = 0.013). Conclusions.Our findings suggest that motorcycles are the vehicles most frequently involved in traffic accidents, which predominantly affect males and children aged 9-12 years, and result in a high prevalence of craniofacial trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Craniofacial trauma in Brazilian child victims of traffic accidents: A single-trauma center analysis

Laureano¹,

Palitot²,

Cavalcanti³

et al. 2021

Dent. Med. Probl.

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“…2 In contrast to facial fractures in adults, pediatric fractures present less predictability, with oblique and Greenstick fractures being more common, increasing their difficulty of diagnosis and management. 3,4 In patients less than 5 years of age, the most common mechanisms of facial fractures are falls (44%), motor vehicles incidents (25%) and interpersonal violence (25%), with variation due to social, cultural and environmental factors. 3,5 Pediatric patients diagnosed with facial fractures exhibit a higher injury severity, with midface fractures being associated with a depressed Glasgow Coma Score (GCS), intracranial hemorrhage, cervical spine injuries, longer length of hospitalization, longer time spent in an intensive care setting and commonly have concomitant injuries (58% of patients).…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Surgical Management of Complex Pediatric Facial Fractures

Mckenzie

Nguyen

2021

Craniomaxillofacial Trauma & Reconstruction Open

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Le Fort fractures in pediatric patients are rare, and their management has increased complexity due to the development of the maxillofacial musculoskeletal complex and dentition. The authors present a case using historic circum-zygomatic wiring with 21st century surgical planning in a 18 month old, who sustained complex Le Fort II and III fractures. Treatment involved surgical planning with dental and stereolithographic models, and the fabrication of a retention modified, occlusal splint. Closed reduction with circum-zygomatic wiring retained by the occlusal splint, for a 3 week period, prior to removal. At 12 month review, the patient had good facial symmetry, cosmesis, profile, and function. The use of circum-zygomatic wiring provided a conservative operative approach, achieving excellent functional and cosmetic results without the potential morbidity of more invasive surgery.

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“…Pediatric craniofacial fractures display oblique fracture patterns, while typical adult fractures exhibit patterns described by LeFort. Pediatric craniofacial fractures are under higher risk of growing fractures (2). With increasing age, the proportion of craniofacial fractures in all pediatric fractures tends to increase (3).…”

Section: Introductionmentioning

confidence: 99%

Can three-dimensional reformatted computed tomography scans be useful to avoid misdiagnoses of skull fractures in pediatric emergency cases?

Çekdemir¹

2020

Erciyes Med J

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Objective: To investigate whether three-dimensional (3-D) reformatted cranial computed tomography (CT) scans may contribute to the avoidance of misdiagnosis of skull fractures in pediatric emergency cases. Materials and Methods:This cross-sectional medical chart review was carried out in the pediatric emergency department of a tertiary care center. Data were derived from pediatric age group patients having head trauma patients whose conventional CT images were obtained at initial admission. Demographic, clinical, and radiological data, the location of the fracture, and possible causes of misdiagnoses were recorded. Results:This study included 27 children (21 males and six females). The average age was 41.92±43.25 (range, 1 to 137) months. The most common etiology for admission to the hospital was fall from height (85.2%). The fractures were detected on the parietal (n=12, 44.4%), frontal (n=7, 25.9%), occipital (n=7, 25.9%) and temporal (n=1, 3.7%) bones. In 12 cases (44.4%), skull fracture could not be detected at their initial admission. Five of these 12 cases were consulted to the radiologist, and diagnosis could not be established even by the radiologist. In 15 pediatric head trauma patients (55.6%), the skull fracture was confirmed by the radiologist. In two cases with an initial failure of diagnosis, 3-D reconstruction allowed the identification of fractures. Conclusion:The findings obtained in this study suggest that 3-D reconstruction of CT scans may increase the accuracy of diagnosis for pediatric skull fractures.

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Pediatric Craniofacial Fractures

Cited by 20 publications

References 13 publications

Craniofacial trauma in Brazilian child victims of traffic accidents: A single-trauma center analysis

Craniofacial trauma in Brazilian child victims of traffic accidents: A single-trauma center analysis

Minimally Invasive Surgical Management of Complex Pediatric Facial Fractures

Can three-dimensional reformatted computed tomography scans be useful to avoid misdiagnoses of skull fractures in pediatric emergency cases?

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