Evaluation of Pediatric Facial Fracture Patients during the COVID-19 Pandemic

Abstract

Background: The COVID-19 pandemic has significantly impacted the provision of health care, including the suspension of elective and nonessential surgeries. This study presents an early effect of the COVID-19 pandemic on the surgical care of pediatric patients with facial fractures. Methods: This study presents a retrospective cohort study of pediatric patients with facial fractures who presented to a pediatric level I trauma center before and during the pandemic. Patients were included regardless of treating specialty, treatment modality, or inpatient status. Results: One hundred nine patients met the inclusion criteria. There were 70 patients in the pre-pandemic cohort and 39 in the pandemic cohort. Mean age in the pre-pandemic cohort was 11.6 ± 4.5 years old and 11.1 ± 4.7 in the pandemic cohort ( P = .623). Majority of patients during the pandemic were female (59%), compared to the predominantly male pre-pandemic cohort (25.7%). Motor vehicle accidents were the most common cause of injury during the pandemic (n = 16, 41.0%), compared to sports in pre-pandemic (n = 21, 30.0%). The most common fracture during the pandemic was nasal fracture (n = 26, 66.7%), which was also the most common fracture in pre-pandemic cohort (n = 59, 84.3%). There were significantly more skull fractures (17.9%, P = .02) and orbital fractures (23.1%, P = .02) during the pandemic, as well as more hospital (33.0%, P = .004) and ICU admissions (17.9%, P = .018). There was no difference in operative rate during the pandemic (41.0%) compared to pre-pandemic (48.6%, P = .449). Conclusions: The COVID-19 pandemic caused a global stoppage of sports and outdoor activities. As a result, more of the fractures that presented to the hospital were due to motor vehicle accidents during the pandemic, leading to proportionally greater rates of admissions and neurological associated injuries.