A retrospective study of causes, management, and complications of pediatric facial fractures

ABSTRACT

Objectives: The objective of this study was to report causes, management options, and complications of facial fractures among children. Materials and Methods: The groups were defined on the basis of age, gender, cause of injuries, location, and type of injuries. The treatment modalities ranged from no intervention, closed reduction alone or with open reduction internal fixation (ORIF). Statistical Analysis: Descriptive statistics were generated by using SPSS software for the entire range of the variables under study. Results: Records of 240 pediatric patients were obtained and a total of 322 fractures were found among a study sample. Among these, one-thirds were due to road traffic accidents (RTAs) (37.26%) and fall injuries (36.64%), making them the leading causes of facial fractures. Mandibular fractures were the most common and they accounted for 46% (n = 148) of all fractures. The highest number of RTA (n = 27) was found in adolescents and fall injuries were more prevalent in preschool children (n = 34). Forty-two percent of the fractures (n = 101) were treated with close treatment using arch bars and splints, followed by ORIF (n = 68). The rest, 29.6% (n = 71), received conservative treatments. Postoperative complications were observed in 18.33% (n = 44) of cases, of which jaw deviation, growth disturbance, and trismus were more frequently encountered. Conclusion: Pediatric facial fractures if not managed properly can cause severe issues; therefore, injury prevention strategies should be strictly followed to reduce pediatric injuries in low socioeconomic countries.

Key words

Complications - facial fractures - fall injuries - road traffic accident - surgical fixation

• REFERENCES

• 1 Peden M. World Report on Child Injury Prevention. Switzerland: World Health Organization; 2008
• 2 Fraga AM, Bustorff-Silva JM, Fernandez TM, Fraga GP, Reis MC, Baracat EC. et al. Children and adolescents deaths from trauma-related causes in a Brazilian city. World J Emerg Surg 2013; 8: 52
• 3 Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385: 117-71
• 4 Ozer S, Yilmaz EI, Bayrak S, Tunc ES. Parental knowledge and attitudes regarding the emergency treatment of avulsed permanent teeth. Eur J Dent 2012; 6: 370-5
• 5 Mir M, Bachani AM, Khawaja H, Afridi S, Ali S, Khan M. et al. The Pakistan National Emergency Department Surveillance Study (Pak-NEDS): Introducing a pilot surveillance. BMC Emerg Med 2015; 15 (Suppl. 02) S1
• 6 Iida S, Matsuya T. Paediatric maxillofacial fractures: Their aetiological characters and fracture patterns. J Craniomaxillofac Surg 2002; 30: 237-41
• 7 Muñante-Cárdenas JL, Olate S, Asprino L, de Albergaria Barbosa JR, de Moraes M, Moreira RW. et al. Pattern and treatment of facial trauma in pediatric and adolescent patients. J Craniofac Surg 2011; 22: 1251-5
• 8 Cole P, Kaufman Y, Hollier Jr LH. Managing the pediatric facial fracture. Craniomaxillofac Trauma Reconstr 2009; 2: 77-83
• 9 Ademuyiwa AO, Usang UE, Oluwadiya KS, Ogunlana DI, Glover-Addy H, Bode CO. et al. Pediatric trauma in Sub-Saharan Africa: Challenges in overcoming the scourge. J Emerg Trauma Shock 2012; 5: 55-61
• 10 Gazal G. Evaluation of the effectiveness of early or delayed treatment upon healing of mandibular fractures: A retrospective study. Eur J Dent 2015; 9: 87-91
• 11 Bartlett SN. The problem of children's injuries in low-income countries: A review. Health Policy Plan 2002; 17: 1-3
• 12 Ghaffar A, Hyder AA, Mastoor MI, Shaikh I. Injuries in Pakistan: Directions for future health policy. Health Policy Plan 1999; 14: 11-7
• 13 Kaban LB, Mulliken JB, Murray JE. Facial fractures in children: An analysis of 122 fractures in 109 patients. Plast Reconstr Surg 1977; 59: 15-20
• 14 Motamedi MH. An assessment of maxillofacial fractures: A 5-year study of 237 patients. J Oral Maxillofac Surg 2003; 61: 61-4
• 15 Abiose BO. The incidence and management of middle third facial fractures at the University College Hospital, Ibadan. East Afr Med J 1991; 68: 164-73
• 16 Vetter JD, Topazian RG, Goldberg MH, Smith DG. Facial fractures occurring in a medium-sized metropolitan area: Recent trends. Int J Oral Maxillofac Surg 1991; 20: 214-6
• 17 Ellis 3rd E, Moos KF, el-Attar A. Ten years of mandibular fractures: An analysis of 2,137 cases. Oral Surg Oral Med Oral Pathol 1985; 59: 120-9
• 18 Zargar M, Khaji A, Karbakhsh M, Zarei MR. Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran. Indian J Med Sci 2004; 58: 109-14
• 19 Ortakoğlu K, Günaydin Y, Aydintuğ YS, Bayar GR. An analysis of maxillofacial fractures: A 5-year survey of 157 patients. Mil Med 2004; 169: 723-7