Injuries In Boys Research Articles

Causes of death up to 10 years after admissions to hospitals for self-inflicted, drug-related or alcohol-related, or violent injury during adolescence: a retrospective, nationwide, cohort study

Emergency hospital admission with adversity-related injury (ie, self-inflicted, drug-related or alcohol-related, or violent injury) affects 4% of 10-19-year-olds. Their risk of death in the decade after hospital discharge is twice as high as that of adolescents admitted to hospitals for accident-related injury. We established how cause of death varied between these groups. We did a retrospective, nationwide, cohort study comparing risks of death in five causal groups (suicide, drug-related or alcohol-related, homicide, accidental, and other causes of death) up to 10 years after hospital discharge following adversity-related (self-inflicted, drug-related or alcohol-related, or violent injury) or accident-related (for which there was no recorded adversity) injury. We included adolescents (aged 10-19 years) who were admitted as an emergency for adversity-related or accident-related injury between April 1, 1997, and March 31, 2012. We excluded adolescents who did not have their sex recorded, died during the index admission, had no valid discharge date, or were admitted with injury related to neither adversity nor accidents. We identified admissions for adversity-related or accident-related injury to the National Health Service in England with the International Classification of Diseases-10 codes in Hospital Episode Statistics data, linked to the Office for National Statistics mortality data for England, to establish cause-specific risks of death between the first day and 10 years after discharge, and to compare risks between adversity-related and accident-related index injury after adjustment for age group, socioeconomic status, and chronic conditions. We identified 1 080 368 adolescents (388 937 [36·0%] girls, 690 546 [63·9%] boys, and 885 [0·1%] adolescents who did not have their sex recorded). Of these adolescents, we excluded 40 549 (10·4%) girls, 56 107 (8·1%) boys, and all 885 without their sex recorded. Of the 333 009 (30·8%) adolescents admitted with adversity-related injury (181 926 [54·6%] girls and 151 083 [45·4%] boys) and 649 818 (60·2%) admitted with accident-related injury (166 462 [25·6%] girls and 483 356 [74·4%] boys), 4782 (0·5%) died in the 10 years after discharge (1312 [27·4%] girls and 3470 [72·6%] boys). Adolescents discharged after adversity-related injury had higher risks of suicide (adjusted subhazard ratio 4·54 [95% CI 3·25-6·36] for girls, and 3·15 [2·73-3·63] for boys) and of drug-related or alcohol-related death (4·71 [3·28-6·76] for girls, and 3·53 [3·04-4·09] for boys) in the next decade than they did after accident-related injury. Although we included homicides in our estimates of 10-year risks of adversity-related deaths, we did not explicitly present these risks because of small numbers and risks of statistical disclosure. There was insufficient evidence that girls discharged after adversity-related injury had increased risks of accidental deaths compared with those discharged after accident-related injury (adjusted subhazard ratio 1·21 [95% CI 0·90-1·63]), but there was evidence that this risk was increased for boys (1·26 [1·09-1·47]). There was evidence of decreased risks of other causes of death in girls (0·64 [0·53-0·77]), but not in boys (0·99 [0·84-1·17]). Risks of suicide were increased following self-inflicted injury (adjusted subhazard ratio 5·11 [95% CI 3·61-7·23] for girls, and 6·20 [5·27-7·30] for boys), drug-related or alcohol-related injury (4·55 [3·23-6·39] for girls, and 4·51 [3·89-5·24] for boys), and violent injury in boys (1·43 [1·15-1·78]) versus accident-related injury. However, the increased risk of suicide in girls following violent injury versus accident-related injury was not significantly increased (adjusted subhazard ratio 1·48 [95% CI 0·73-2·98]). Following each type of index injury, risks of suicide and risks of drug-related or alcohol-related death were increased by similar magnitudes. Risks of suicide were significantly increased after all types of adversity-related injury except for girls who had violent injury. Risks of drug-related or alcohol-related death increased by a similar magnitude. Current practice to reduce risks of harm after self-inflicted injury should be extended to drug-related or alcohol-related and violent injury in adolescence. Prevention should address the substantial risks of drug-related or alcohol-related death alongside risks of suicide. UK Department of Health.

CSM 2017 Sports Physical Therapy Section Poster Presentations (Abstracts SPO1–SPO152)

CSM 2017 Sports Physical Therapy Section Poster Presentations (Abstracts SPO1–SPO152)

Animal bite of genitalia in a child: A rare case of anterior urethral injury

Pediatric genital injuries are relatively uncommon. Urethral injuries occur in 3.4% of genitourinary injuries in children. The majority of urethral injuries in boys are to the anterior urethra. We review the diagnosis and management of anterior urethral injuries in the setting of a dog bite to the genitalia in child.

Uncovering the burden of intentional injuries among children and adolescents in the emergency department.

IntroductionIn low- and middle-income countries, injuries are a leading cause of mortality in children. Much work has been done in the context of unintentional injuries but there is limited knowledge about intentional injuries among children. The objective of this paper was to understand the characteristics of children with intentional injuries presenting to emergency departments in Pakistan.MethodsThe data was from the Pakistan National Emergency Departments Surveillance (Pak-NEDS), conducted from November 2010 to March 2011 in seven major emergency departments of Pakistan. Data on 30,937 children under 18 years of age was collected. This paper reports frequency of intentional injuries and compares patient demographics, nature of injury, and discharge outcome for two categories of intentional injuries: assault and self-inflicted injuries.ResultsIntentional injuries presenting to the emergency departments (EDs) accounted for 8.2% (2551/30,937) amongst all other causes for under 18 years. The boy to girl ratio was 1:0.35. Intentional injuries included assault (n = 1679, 65.8%) and self-inflicted injuries (n = 872, 34.2%). Soft tissue injuries were most commonly seen in assault injuries in boys and girls but fractures were more common in self-inflicted injuries in both genders.ConclusionIntentional injury is one of the reasons for seeking emergency treatment amongst children and a contributor to morbidity in EDs of Pakistan. Moreover, such injuries may be underestimated due to lack of reporting and investigative resources. Early identification may be the first step leading to prevention.

‘If You Don’t Want to Get Hurt, Don’t Play Hockey’: The Uneasy Efforts of Hockey Injury Prevention in Canada

Ice hockey is known for its speed, skill and aggression. This paper uses an analyses of injuries in boys’ minor leagues and primary documents to examine competing discourses that surround participant safety which give meaning to broader hockey practices. We problematize a prevailing discourse that preserves the physicality of Canadian hockey and an emerging reverse discourse that prioritizes player safety. Theoretically informed by Foucault’s concepts of discourse, knowledge and power relations, we interpret the relationships between these two competing discursive streams which have created a public controversy, particularly concerning body checking, and intensified a polarizing national debate. Ultimately, we argue that these discourses impact the implementation of progressive injury prevention initiatives in minor hockey and youth sport.Le hockey sur glace est réputé pour être rapide, technique et violent. Cet article utilise une analyse des blessures et documents de ligues mineures masculines afin d’examiner les discours qui circulent à propos de la sécurité des participants et qui sont reliés aux pratiques plus générales du sport. Nous mettons en évidence un discours dominant qui préserve la physicalité du hockey canadien et un discours contraire émergeant qui priorise la sécurité des joueurs. En nous appuyant au niveau théorique sur les concepts foucaldiens de discours, savoir et relations de pouvoir, nous interprétons les relations entre ces deux courants discursifs en compétition qui ont créé une controverse publique, particulièrement en ce qui concerne les mises en échec, et intensifié un débat national polarisé. En bout de ligne, nous avançons que ces discours influencent l’implantation d’initiatives progressistes de prévention des blessures dans le hockey mineur et le sport pour les jeunes.

Relationships between community social capital and injury in Canadian adolescents: a multilevel analysis

BackgroundCharacteristics of social environments are potential risk factors for adolescent injury. Impacts of social capital on the occurrence of such injuries have rarely been explored.MethodsGeneral health questionnaires were completed by...

Sex differences in children with severe health conditions: Causes of admission and mortality in a Pediatric Intensive Care Unit.

Based on the existing sex differences in mortality rates in children, we would like to explore whether girls and boys respond differently under severe health conditions, in terms of mortality and cause of admission. We analyzed demographic characteristics (age and sex), causes of admission, clinical parameters, and mortality in a sample of 2,609 patients from a Pediatric Intensive Care Unit (PICU) in a children's hospital in Barcelona, Spain. PICU admittance was significantly higher in boys (57.5% vs. 42.5%) whereas PICU mortality was significantly higher in girls (4.9% vs. 3.3%). Female sex was a risk factor for PICU in-hospital mortality (OR = 1.55, P = 0.033), while increasing age had a protective effect (OR = 0.808, P = 0.021). In cases of PICU mortality, girls died from a broader range of causes and boys were more affected by respiratory and polytraumatic injuries. Boys were affected by polytraumatic injuries throughout the year, less frequently in winter, while girls showed a higher occurrence in holiday months. Although more boys were admitted to the PICU, a significantly higher number of girls died. Younger age and higher occurrence of nosocomial infection among girls could explain this finding. More frequent polytraumatic injuries in boys could reflect an increased exposure to risky activities and/or more careless behavior.

Does Intentional or Unintentional Contact in Youth Ice Hockey Result in More Injuries?

OBJECTIVE: : To determine whether boys' ice hockey programs have higher injury rates from intentional body contact or from unintentional contact and whether allowing body checking increases the rate of injuries. DESIGN: : Cohort study over 5 seasons. Many of the participants played for more than one season. SETTING: : Youth ice hockey programs during the years 2002-2007 in Ontario, Canada. PARTICIPANTS: : The study included between 2594 and 2730 boys aged 4-18 years in each season, for a total of 13 292 player-years. ASSESSMENT OF RISK FACTORS: : Player time was estimated from the trainers' reports of the number of games and practices during the season for each team, with the assumption that all players attended practices and participated in one-third of each game. Risk factors included team age group (5 groups), level of play (house league, select, and representative [rep]), games versus practices, and whether checking was permitted. House league teams were not permitted to body check, but checking was allowed in select teams from 11 years (peewee), and rep teams from 9 years. MAIN OUTCOME MEASURES: : The main outcome measures were rates of injury in relation to unintentional contact, intentional contact, and body checking and across age group, level of play and games and practices. Injuries were reported by the team trainers using the Hockey Canada injury report form, which included a physician's statement of the diagnosis and information on the cause of injury. Intentional contact (body checks) included contact with an opposing player in games, with a team member during practices, and illegal contacts, such as cross-checking or slashing. Unintentional contacts were collisions between same-team players during games, collisions with the boards, falling on the ice, or being hit by the puck. Time missed because of injury was recorded. Injury data were checked by phone calls to 22 families and found to be reliable. An injury required missing ≥1 day of activity. MAIN RESULTS: : The total number of injuries for the 5 seasons was 247 (range per season, 40-60). Overall, unintentional collision injuries accounted for 66% (95% confidence interval [CI] 60%-72%) of injuries (house/select leagues, 69.3% and rep leagues, 60.8% of unintentional contact injuries). Greater numbers of serious injuries (concussions, contusions, sprains/strains, fractures, and dislocations) occurred in unintentional collisions than in intentional collisions (P for each category, 0.20). Including all levels of play, in comparisons with peewee (age 11-12 years), younger boys (7-10 years) had a lower rate of injuries from all causes (P ≤ 0.011) and older boys (13-18 years) tended to have a higher rate of injuries from intentional causes (P ≤ 0.058) but not unintentional causes. The rates of injuries in games increased with age and league level (top rate per 1000 hours of play, bantam rep, 10.64), but rates of injuries in practices were low and relatively stable (range, 0.00-0.82/1000 hours of play). In divisions that allowed body checking versus those that did not, RR for injuries from intentional contact was 3.95 (95% CI, 0.80-19.50), from unintentional contact, 3.27 (95% CI, 1.07-10.00), and including all injuries, 3.75 (95% CI, 1.51-9.34). CONCLUSIONS: : More injuries and more serious injuries in boys' ice hockey occurred from unintentional collisions than from intentional contact. In divisions where body checking was allowed, almost 4 times as many injuries occurred from both intentional and unintentional contacts. Language: en

P1-469 Socioeconomic status of injured children in Zanjan, Iran

IntroductionInjuries are one of public health priorities in Iran. Information on injuries in children and its related factors are less well known. The aim of this study was to describe...

Overuse Injuries in High School Runners: Lifetime Prevalence and Prevention Strategies

To evaluate lifetime prevalence and risk factors for overuse injuries in high school athletes currently participating in long-distance running and provide recommendations for injury prevention strategies. Retrospective study design. Twenty-eight high schools in the San Francisco Bay Area. A total of 442 female and 306 male athletes, ages 13-18 years, who are on cross-country and track and field teams. Online survey with questions that detailed previous injuries sustained and risk factors for injury. Previous overuse injuries and association of risk factors to injury (including training variables, dietary patterns, and, in girls, menstrual irregularities). Previous injuries were reported by 68% of female subjects and 59% of male subjects. More injury types were seen in girls (1.2 ± 1.1 versus 1.0 ± 1.0, P < .01). Both genders had similar participation in running (2.5 ± 2.2 versus 2.3 ± 2.1 years), and previous injury prevalence followed a similar pattern: tibial stress injury (girls, 41%; boys, 34%), ankle sprain (girls, 32%; boys, 28%), patellofemoral pain (girls, 21%; boys, 16%), Achilles tendonitis (girls, 9%; boys, 6%), iliotibial band syndrome (girls, 7%; boys, 5%), and plantar fasciitis (girls, 5%; boys, 3%). Higher weekly mileage was associated with previous injuries in boys, (17.1 ± 11.9 versus 14.1 ± 11.5, P < .05) but not in girls (14.4 ± 10.2 versus 12.6 ± 11.8, not significant). A strong association between higher mileage and faster performances was seen in both groups. No association between previous injury and current dietary patterns (including disordered eating and calcium intake) or menstrual irregularities was seen. The majority of athletes currently participating in high school cross-country and track and field have a history of sustaining an overuse injury, with girls having a higher prevalence of injury. A modest mileage reduction may represent a modifiable risk factor for injury reduction. Future research is needed to evaluate the effects of incorporating a comprehensive strength training program on the prospective development of overuse injury and performance in this population.

Analysis of nonsexual injuries of the male genitals in children and adolescents

This study analysed nonsexual male genital injuries in boys with regards to aetiology, age, management and outcome. Patients were identified from the hospital database (between 1999 and 2009) were analysed retrospectively. Seventy-four patients (2-17 years) were identified which included 24 toddlers and small children (2-5 years), 36 school age children (6-12 years) and 14 adolescents (13-17 years). Traumas were related to falls (n=14), kicks (n=11), sport (n=10), toilet seats (n=9), motor vehicles (n=8), bicycle (n=4), outdoor activities (n=4) and others causes (n=14). The leading cause of injuries in (i) toddler and small children was related to toilet seat (n=7) and falls (n=7), (ii) school age children to sport (n=8), kicks (n=7) and falls (n=6), and (iii) adolescents to motorcycle accidents (n=5). There were 45 scrotal and 29 penile injuries ranging from lacerations to contusions. Sixty-eight patients required hospital stay (0.5-36 days, Σ=2.4 days). Follow-up examinations were uneventful, except for one minor wound infection. Nonsexual traumas to the male external genitalia occur mostly in 6- to 12-year-old boys, with sport accidents, kicks and falls being the major causes. Scrotal and penile lacerations and testicular contusions are the most common injuries. Complications after injuries to the male genitals in children are rare.

Urban–rural differences in school injury patterns: findings from 34 cities in 2005–2007

To examine patterns of school injuries among kindergarten, primary, middle, high school and special school students by level of urbanisation in 34 cities.School injuries reported to School Safety Insurance Federation...

Effects Of A School-based Injury Prevention Program On Acute Physical Activity Injury Incidence And Severity.

The health benefits of regular physical activity in children are widely known. Participation in physical activity, however, also leads to unwanted side effects such as acute physical activity related injuries. Although most injuries in children are not life threatening, they may coincide with direct pain, short-term disability, school absence and long-term consequences, all leading to high direct and indirect costs. PURPOSE: To investigate the effectiveness of a school-based injury prevention program (iPlay) on acute physical activity injury incidence and severity in Dutch children aged 10-12 years. METHOD: The iPlay-study is a cluster randomised controlled trial including 2,210 children from 40 primary schools. The 20 intervention schools received the iPlay-program during one school year whereas the control schools followed the regular curriculum. The iPlay-program targeted acute physical activity injuries and consisted of newsletters, posters, a website, and simple exercises to be carried out during physical education (PE) classes. Primary outcome measures were acute physical activity injury incidence and severity continuously monitored by the PE teacher. Group comparisons were made using the Cox proportional hazard regression analyses. RESULTS: Results showed that the overall physical activity injury incidence per 1,000 hours of physical activity participation was significantly reduced in the intervention group (Hazard Ratio (HR) = 0.68, 95%CI:0.49-0.95). Specifically, during organized sports activities injury incidence was strongly reduced (HR = 0.55, 95%CI:0.31-0.98). Furthermore, in girls injury incidence during leisure time physical activities was considerably reduced (HR = 0.38, 95%CI:0.18-0.82). In boys in the intervention group, the severity of the overall physical activity injuries was significantly lower (OR = 0.12, 95%CI:0.02-0.72). CONCLUSION: This study revealed that a school-based intervention-program was effective in reducing acute physical activity injury incidence in children aged 10-12 years. The program also decreased the severity of the physical activity injuries in boys.

Genital injuries in boys and abuse

Aims: To describe a cohort of boys with genital injuries in whom child abuse was suspected. Methods: Boys with genital injury (penile and/or scrotal) and referred to paediatricians in Leeds,...

Nonfatal Injuries Among Middle-School and High-School Students in Guangxi, China

We described nonfatal injuries and calculated injury rates among middle-school and high-school students in Guangxi, China. Students were selected using multistage randomizing techniques, and nonfatal injuries in 1840 students from February 2002 to January 2003 were monitored with standardized injury forms. Risk factors for injury were identified in multivariate analyses. The annual overall injury rate was 32.3 per 100 students. Boys had a significantly higher injury rate than the girls (34.8 vs 30.3 per 100 students), and a significantly higher proportion of injuries in boys was caused by other students (28.1% vs 19.4%). A higher proportion of injuries in girls (40.7%) occurred at home. For both boys and girls, sports were the most common activities associated with injury. Injuries from falls were the leading cause of injury, and extremities were most frequently injured. Gender, age, ethnicity, and family income levels were identified as significant risk factors for injury in multivariate analyses. Nonfatal injuries in middle-school and high-school students should be recognized as a significant public health concern in China.

Playing with fire: images of fire on toy packaging.

Despite prevention efforts designed to teach children that fire is not a toy, each year hundreds of children, primarily male, are injured while playing with fire. Mass-produced toys and games shape children's behaviors, and the fire images on toy packaging may send the message that fire is fun rather than dangerous. The purpose of this study was to determine the frequency of male fire-related injuries at our burn center and to investigate the use of fire images in toy packaging. An aisle-by-aisle search was conducted at a national toy store. Toys with fire images on their packaging were identified. Target gender and the setting in which the fire was displayed also were recorded. Only toys with clearly visible flames on their packaging were included. We reviewed our TRACS database from April 1997 to May 1999 for fire-related injuries to children admitted to our institution as a result of playing with fire. Review of toy stores revealed 404 toys with packaging containing fire images. Of these, 97% (393 of 404) were targeted to males. Video games were the leading category of flame-related packaging (208 of 404), followed by toy car/truck displays (84 of 404). Packaging for girls' toys had safe and contained settings, whereas boys' toys used settings that were uncontrolled and associated with speed and weapons. A total of 59 children, 52 males and 7 females, with a mean age of 10 +/- 0.6 years and mean TBSA burn of 12.3 +/- 2.1% were admitted to our facility with fire-related injuries during the study interval. Children imitate life with toys and use play to experiment with new behavior. Boys are receiving a powerful, consistent message from images of fire on toy packaging. These advertisements may help to contribute to the higher incidence of fire-related injuries in boys.

Urethral trauma in children.

We report our 12-year experience in the management of urethral injuries in nine children, six boys and three girls. The most common mechanisms of injury were motor vehicle accidents, followed by straddle injuries. All the injuries in boys involved the anterior urethra, and in girls the proximal or mid-urethra. There were associated injuries in five, including three pelvic fractures. All children were investigated with a retrograde urethrogram. Four were treated non-operatively with insertion of a urethral catheter. Of the remaining five, one had drainage of a penile haematoma, one cystourethroscopy, two insertion of urinary and suprapubic catheters, and one open cystotomy and passage of a guide wire with antegrade passage of a urethral catheter. Complications included one urinary tract infection, one urethral fistula, one urethrovaginal fistula, and two urethral strictures. Final outcome was satisfactory in all nine children.

A case-control study of child bicycle injuries: relationship of risk to exposure

In order to assess the relationship of the risk of injury requiring hospital attendance in children riding bicycles to sociodemographic factors and to measures of exposure, a population-based case-control study is being undertaken in a large area of suburban Melbourne, Australia. Particular attention is given to the measurement of individual exposure in several dimensions. Analysis of interim data from 109 cases and 118 controls shows that 51% of injuries occurred while the child was playing rather than making a trip on the bicycle and only 22% involved another vehicle. Boys used bicycles more commonly than girls but there was minimal evidence of an increased risk of injury in boys, adjusting for exposure. There was no evidence for an age trend in injury risk, but children from families in the lowest income category were at significantly increased risk. Exposure measures showed complex patterns of association with injury risk. Estimated time spent riding was more closely associated with risk than distance travelled, with an odds ratio of 2.2 (95% confidence interval 1.1–4.2) for children riding for more than 3 hours per week compared to children riding less than 1 hour. Riding more than 5 km on the sidewalk was also associated with increased risk (odds ratio 3.1, 95% CI 1.1–8.5). The elevated risk associated with sidewalk riding may be due to difficulties in negotiating uneven surfaces. The case-control study provides an ideal design for this type of investigation but valid and reliable measurement of exposure is difficult.

Knowledge of safety of high and low active-impulsive boys: Implications for child injury prevention

Preventing childhood injuries is a worthy endeavor for child psychologists, because injury causes more fatalities among the young than all other diseases combined. Highly active, impulsive boys appear to be at special risk for injury occurrence. In this study, kindergarten, third-, and sixth-grade boys (n = 95) who were rated by their teachers as high or low on the Inattention/Overactivity factor of the Iowa Conners (Loney and Milich, 1982) sewed as participants and their knowledge of safety and prevention was assessed. Results indicated that within each grade level, boys displayed comparable safety and prevention knowledge, regardless of their level of activity-impulsivity. These data suggest that there is no apparent deficit of knowledge of safety or prevention to account for greater risk of injury in boys rated high on activity and impulsivity. The primary prevention approach of safety education is questioned as a comprehensive prevention method for this high-risk target group. Language: en

Pediatric facial farctures: Evolving patterns of treatment

This study reviews the treatment of facial trauma between October 1986 and December 1990 at a major pediatric referral center. The mechanism of injury, location and pattern of facial fractures, pattern of facial injury, soft tissue injuries, and any associated injuries to other organ systems were recorded, and fracture management and perioperative complications reviewed. The study population consisted of 137 patients who sustained 318 facial fractures. Eighty-one patients (171 fractures) were seen in the acute stage, and 56 patients (147 fractures) were seen for reconstruction of a secondary deformity. Injuries in boys were more prevalent than in girls (63% versus 37%), and the 6- to 12-year cohort made up the largest group (42%). Most fractures resulted from traffic-related accidents (50%), falls (23%), or sports-related injuries (15%). Mandibular (34%) and orbital fractures (23%) predominated; fewer midfacial fractures (7%) were sustained than would be expected in a similar adult population. Three quarters of the patients with acute fractures required operative intervention. Closed reduction techniques with maxillomandibular fixation were frequently chosen for mandibular condyle fractures and open reduction techniques (35%) for other regions of the facial skeleton. When open reduction was indicated, plate-and-screw fixation was the preferred method of stabilization (65%). The long-term effects of the injuries and the treatment given on facial growth remain undetermined. Perioperative complication rates directly related to the surgery were low. This study reviews the treatment of facial trauma between October 1986 and December 1990 at a major pediatric referral center. The mechanism of injury, location and pattern of facial fractures, pattern of facial injury, soft tissue injuries, and any associated injuries to other organ systems were recorded, and fracture management and perioperative complications reviewed. The study population consisted of 137 patients who sustained 318 facial fractures. Eighty-one patients (171 fractures) were seen in the acute stage, and 56 patients (147 fractures) were seen for reconstruction of a secondary deformity. Injuries in boys were more prevalent than in girls (63% versus 37%), and the 6- to 12-year cohort made up the largest group (42%). Most fractures resulted from traffic-related accidents (50%), falls (23%), or sports-related injuries (15%). Mandibular (34%) and orbital fractures (23%) predominated; fewer midfacial fractures (7%) were sustained than would be expected in a similar adult population. Three quarters of the patients with acute fractures required operative intervention. Closed reduction techniques with maxillomandibular fixation were frequently chosen for mandibular condyle fractures and open reduction techniques (35%) for other regions of the facial skeleton. When open reduction was indicated, plate-and-screw fixation was the preferred method of stabilization (65%). The long-term effects of the injuries and the treatment given on facial growth remain undetermined. Perioperative complication rates directly related to the surgery were low.