Comparison of Pediatric and Adult Mandibular Fractures: Identifying Differences in Presentation and Management Using a National Trauma Database.

Abstract

Facial fractures in children are less common than in adults but can lead to significant long-term complications, including growth abnormalities and functional issues. Mandibular fractures are the most common facial fractures in both age groups, yet there is no consensus on optimal management strategies. This study investigates the epidemiology, presentation, treatment, and outcomes of mandibular fractures in pediatric versus adult populations. The authors conducted a retrospective, population-based study using 2016 to 2019 data from the National Trauma Data Bank. Patients with mandibular fractures were categorized into pediatric (below 18y) and adult (18y or above) groups. The authors analyzed demographics, fracture mechanism, treatment modality, hospital outcome, and complication data. Of the 42,866 patients with operative mandibular fractures, 3968 were pediatric (mean age: 13.3y), and 38,898 were adult (mean age: 36.2y). The primary fracture etiology for both groups was being struck, followed by motor vehicle incidents and falls. Pediatric patients were more frequently treated at level I trauma centers, had shorter times for surgical intervention, and were more frequently transferred to other facilities compared to adults. Antibiotic use was similar between groups, and hospital complications were infrequent, with low rates of infection and unplanned return to the operating room. Mandibular fractures in children, though less common than in adults, exhibit unique epidemiological and management characteristics. Children were more frequently transferred for care and received surgical intervention sooner than adults. Antibiotic use and complication rates were low and similar across both groups. Further research is needed to establish specific treatment guidelines for pediatric mandibular fractures.