Paediatric Oral and Maxillofacial Trauma - Review of Literature

Abstract

Abstract Approximately 5% to 15% of all facial fractures occur in children. The prevalence of pediatric facial fractures is lowest in infants and increases progressively with age. Children younger than 5-years contribute to only 1.0% of facial fractures, whereas 1.0 to 14.7% occurs in patients older than 16-years. The trauma occurring at this age is usually related to increased physical activity and participation in sports during puberty and adolescence. The most common cause is motor vehicle accidents [5-80.2%], followed by accidental causes, such as falls [7.8-48%] sports-related injury is the next most common cause [4.4-42%], violence [3.7- 61.1%] and other causes [9.3%]. Children usually are more susceptible to greenstick fractures and have a higher resistance to facial fractures because of the abundance of cartilage and cancellous bone, low mineralization and underdeveloped cortex, along with the more flexible suture lines and indistinct cortico-medullary junction which confers greater elasticity and flexibility on the pediatric facial skeleton. CT is necessary to confirm the diagnosis. Treatment should be noninvasive and conservative whenever possible in order to prevent growth disturbances and when surgery is necessary, the least invasive procedure and least intrusive devices (e.g., the fewest and smallest plates) should be used. Mandibular fractures are the most frequently occurring fractures in pediatrics, followed by nasal fractures, orbital, frontal and midfacial fractures.