Pediatric facial injuries: It′s management

Abstract

Background:Facial injuries in children always present a challenge in respect of their diagnosis and management. Since these children are of a growing age every care should be taken so that later the overall growth pattern of the facial skeleton in these children is not jeopardized.Purpose:To access the most feasible method for the management of facial injuries in children without hampering the facial growth.Materials and Methods:Sixty child patients with facial trauma were selected randomly for this study. On the basis of examination and investigations a suitable management approach involving rest and observation, open or closed reduction and immobilization, trans-osseous (TO) wiring, mini bone plate fixation, splinting and replantation, elevation and fixation of zygoma, etc. were carried out.Results and Conclusion:In our study fall was the predominant cause for most of the facial injuries in children. There was a 1.09% incidence of facial injuries in children up to 16 years of age amongst the total patients. The age-wise distribution of the fracture amongst groups (I, II and III) was found to be 26.67%, 51.67% and 21.67% respectively. Male to female patient ratio was 3:1. The majority of the cases of facial injuries were seen in Group II patients (6-11 years) i.e. 51.67%. The mandibular fracture was found to be the most common fracture (0.60%) followed by dentoalveolar (0.27%), mandibular + midface (0.07) and midface (0.02%) fractures. Most of the mandibular fractures were found in the parasymphysis region. Simple fracture seems to be commonest in the mandible. Most of the mandibular and midface fractures in children were amenable to conservative therapies except a few which required surgical intervention.

Internal fixation of mandibular angle fractures using one miniplate in Greek children: A 5-year retrospective study

“…Conservative treatment in the form of long-term IMF with the aforementioned difficulties is not commonly applied in pediatric patients and is selectively used for 7e10 days following open reduction and internal fixation in cases of displaced non-condylar mandibular fractures (Pape et al, 1999;Zimmermann et al, 2006;Singh et al, 2011). Intraoral approach in MAFs, although difficult, has been proposed for the placement of an osteosynthesis plate even at the lower border of the mandible (Choi et al, 1995;Ellis, 2010b).…”

“…The incidence of MAFs in 12 years old children or less is low but increases with age (Thor en et al, 1992;Iida and Matsuya, 2002); it has been reported to range between 4 and 19.7% among all mandibular fractures (Thor en et al, 1992;Iida and Matsuya, 2002;Ferreira et al, 2005;Singh et al, 2011), whereas in adults, MAFs account for up to 30% of the total mandibular fractures (Chrcanovic, 2013). Findings of the present retrospective study (13%, 7/54 fracture sites) are in agreement with literature reports.…”

“…The condylar region is the most commonly affected site of mandibular fractures in children followed by symphysis, body and angle fractures (Ferreira et al, 2005;Zimmermann et al, 2006;Singh et al, 2011;Osunde et al, 2013). Mandibular angle fractures (MAFs) have low incidence in children, have been poorly studied and their treatment remains controversial with complication rates rising up to 32% in adults (Ellis, 1999).…”

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

“…9 Most condylar fractures are caused by indirect forces transmitted to the condyle from a blow elsewhere, 10 and traffic accidents, including bicycle crashes, are the main causes of these fractures in children. [11][12][13][14] With adequate molar support and the teeth in occlusion, little or no displacement is likely to be sustained, whereas the full force will be transmitted to the condyles if the mouth is wide open. 15 Ongoing controversy exists on the management of pediatric mandibular condylar fractures.…”

Traumatismos Maxilofaciais em Crianças e Adolescentes em Campina Grande, Paraíba, Brasil

“…Quanto aos tipos de fraturas faciais, este estudo encontrou que as fraturas nasais e do complexo zigomático-orbitário foram as mais frequentes. Alguns autores 14 reportaram ser os ossos nasais os mais acometidos, enquanto outros 3,8,18,19,21,27 afirmam que as fraturas mandibulares são as mais predominantes em indivíduos menores de 18 anos.…”