Pediatric Maxillofacial Trauma Research Articles

Pediatric Trauma During COVID-19: What Have We Learned?

BackgroundIn December 2019, an outbreak of a novel pneumonia-like illness, COVID-19 (C-19), emerged in Wuhan, China. In March 2020, as the incidence of C-19 rose, the Israeli government, like that of other nations, declared a national state of emergency, and a full, general lockdown was announced. PurposeThe purpose of this study is to determine the incidence and characteristics of pediatric maxillofacial trauma presentation during the 2020 C-19 lockdown restrictions and compare them to periods outside lockdown between 2019 and 2020 (Pre-C-19). Study design, setting, sampleA retrospective cohort study was conducted and included all pediatric patients (0-18 years) referred to the emergency department (ED) at Tzafon Medical Center, Israel, and diagnosed with maxillofacial injuries. Patients with missing demographic data and patients who did not complete the medical examination were excluded. Predictor/exposure/independent variableThe exposure variable is the date of injury – 2020 C-19 lockdown period compared to the previous year (Pre-C-19). Main outcome variable(s)The main outcome variable was the number of pediatric maxillofacial trauma ED arrivals out of total pediatric ED arrivals and out of total maxillofacial ED arrival. CovariatesCovariates included patient demographics, etiology and place of injury. AnalysesThe association between categorical variables was tested using Fisher exact test or Chi-square test for binary variables with relative risk (RR) when appropriate, logistic regression model used to predict outcome variable. P-values were 2-tailed and statistical significance was defined as P < 0.05. ResultsThe study sample comprised 1174 patients. RR of presenting with oral and maxillofacial trauma out of all pediatric ED patients was 1.85 comparing C-19 period to Pre-C-19 period (CI [1.65 ; 2.073], p < 0.0001). Most of the injuries recorded during the C-19 restrictions occurred in the domestic environment (56.1% compared to 47.5% in Pre-C-19, p < 0.001). Incidences necessitating treatment increased from 45.8% to 55% during C-19 (p = 0.002). ConclusionsDuring C-19 there was a higher rate of pediatric injuries compared to Pre-C-19. The incidence of domestic oral and maxillofacial injuries increased despite the considered home safety.

Paediatric Maxillofacial Trauma: An Overview of Incidence, Challenges and Management

Abstract Introduction: Paediatric maxillofacial trauma poses a significant threat to children and their well-being, with increasing incidence globally, particularly in developing nations. This study, conducted over 5 years at a private medical college and hospital in Varanasi, Uttar Pradesh, analysed 225 cases of paediatric maxillofacial injuries, providing a comprehensive overview of incidence, challenges and management strategies. Materials and Methods: The male predominance (2:1 ratio) aligns with existing literature, emphasising the higher susceptibility of boys to traumatic injuries. A concerning 40% of cases involved a loss of consciousness, underscoring the severity of these incidents. Timely medical attention is crucial, as revealed by the finding that approximately 20% of patients sought help more than 24 h after the incident. Results: Head injuries, identified in 35 patients, exhibited a positive correlation with delayed admission times, emphasising the need for prompt evaluation, especially for potential intracranial complications. The study explored causes, with self-falls being the most prevalent (45%), while child abuse instances were absent. Age-specific patterns were noted, emphasising the need for targeted preventive measures. Soft-tissue injuries (58% of cases) were dominated by lacerations and abrasions, with age-specific correlations providing insights for clinicians. Hard-tissue injuries, including dentoalveolar and mandibular fractures (229 cases), showcased a prevalence of displaced fractures, primarily managed conservatively. Surgical interventions, especially open reduction and internal fixation, were common for mandibular fractures. Conclusion: This study contributes nuanced insights into paediatric maxillofacial trauma, informing clinical practices and guiding preventive strategies. Statistically significant associations between various factors offer a foundation for evidence-based practices, ultimately aiming to reduce morbidity and mortality rates in the paediatric population.

Epidemiology and Pattern of Pediatric Maxillofacial Trauma: A 5-Year Retrospective Study.

To analyze the epidemiology, pattern, and prevent measurement of pediatric maxillofacial trauma in Xinjiang, China. Clinical records of patients aged 0 to 18 years with maxillofacial trauma over the 5 years were reviewed. Epidemiological features of data were collected for the cause of injury, age and sex distribution, frequency and type of injury, localization and frequency of soft tissue injuries, facial bone fractures, and presence of associated injuries. Statistical analyses performed included descriptive analysis, χ 2 test, and logistic regression analyses. Among the 450 patients, 333 were male and 117 were female, with a male-to-female ratio of 3.8:1, the mean age was 9.2±5.4 years; 223 cases were soft tissue injuries and 227 cases were maxillofacial fractures. The 16 to 18-year-old group was the highest, with the prevalence of maxillofacial fractures. The most common cause of pediatric maxillofacial trauma was traffic injuries. The incidence of maxillofacial trauma in pediatric patients correlates with a number of factors, including age, sex, and etiology of trauma. The 16 to 18-year-old group is the most prevalent group for maxillofacial trauma in pediatric patients, and traffic accidents are the leading cause of maxillofacial trauma in pediatric patients.

Pediatric Maxillofacial Trauma: Insights into Diagnosis and Treatment of Mandibular Fractures in Pediatric Patients.

To assess the diagnostic and therapeutic approaches in pediatric mandibular fractures with regards to fracture pattern and localization. This retrospective study included patients under the age of 17 years that presented to the Department of Oral and Maxillofacial Surgery at Charité-Universitätsmedizin Berlin with mandibular fractures over an 11-year long period (2010-2020). Medical records were analyzed for age, gender, injury mechanism, clinical presentation, imaging modalities, fracture pattern, and fracture management. Statistical analyses included descriptive statistics, normality testing, and Mann-Whitney U tests. A total of 91 pediatric patients (23 females and 68 males) presented with mandibular fractures. The majority of mandibular fractures occurred in patients aged 13-16 years (67.0%, n = 61). The main causes were activities of daily life (34.1%), followed by assault (25.3%). Malocclusion and pain upon mandibular joint compression were documented in 72.5% and 51.7% of patients, respectively. The most frequently applied radiological diagnostic tool was a panoramic X-ray (49.5%). The main fracture patterns were single (42.9%) and double fractures (48.4%). An age-adapted surgical approach using open reduction and internal fixation (ORIF) was the most frequent management (61.5%). A conservative approach was favored in cases of condylar head fractures. Resorbable plates were used in eight cases of ORIF (8.8%). Treatment regimens should be carefully selected based on the unique anatomy of the pediatric patient with regards to centers of growth and dentition phase, to restore stomatognathic function and to maintain adequate skeletal growth and eruption of teeth. This study illustrates the challenges of mandibular fracture management in the pediatric patient. Hofmann E, Koerdt S, Heiland M, et al. Pediatric Maxillofacial Trauma: Insights into Diagnosis and Treatment of Mandibular Fractures in Pediatric Patients. Int J Clin Pediatr Dent 2023;16(3):499-509.

Prevalence of paediatric maxillo-facial trauma in India: a single centre, 5-year retrospective study

Background: Trauma is one of the most common reasons of fatalities worldwide. A study on the prevalence is important to know about the common causes of trauma. Such studies and data boost the campaigning on prevention and increasing awareness against trauma.Methods: Traumatised patients who reported to the emergency or casualty department of Mahatma Gandhi hospital, Sitapura, Jaipur or out-patient department of department of oral and maxillofacial surgery of Mahatma Gandhi Dental college and hospital, Sitapura, Jaipur between January 2017 and December 2021 were selected for this study. The hospital records of patients were retrospectively analysed for age, gender, etiology of trauma, distribution of fracture in facial structure and among maxilla and mandible, treatment procedures patients underwent in different age groups.Results: 371 traumatic patients were analysed for paediatric maxillofacial trauma. The commonly affected age group were found to be 13-16 years, with road traffic accidents being the most common etiology leading to mandible green stick fracture with dentoalveolar and Lefort II fracture in majority of cases. The frequent treatment option was found to be either conservative management, circummandibular wiring, splinting or Open Reduction and Internal Fixation according to age groups.Conclusions: The facial injury pattern is influenced by growth and age of patient. The effect and the management of trauma depend on the age of child. Road traffic accident are the most common cause of trauma and mandible bone is the most frequently fractured bone with dentoalveolar fracture during facial injuries. A clear male predilection has also been observed.

Indications and complications regarding titanium osteosynthesis in pediatric maxillofacial trauma: A scoping review and critical appraisal

With the advent of biodegradable osteosynthesis material, titanium osteosynthesis for ORIF in pediatric maxillofacial trauma is not as indisputable as before. The aim of this study was to conduct a scoping review to assess the indications, complications of ORIF with titanium osteosynthesis material in pediatric maxillofacial trauma.A systematic search was conducted in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, gray literature (ICTRP and clinicaltrials.gov) for studies published until April 2022. 3436 studies were screened and finally 13 articles, compromising a sample of 340 pediatric patients were included after full text reading.Reported complications were infection (6.5% of population), malocclusion (5% of population) and dental maleruption (8% of population). Influence on future growth could not be assessed due to short and heterogeneous follow-up periods. Eight of the thirteen studies concluded to a positive and predictable outcome using titanium ORIF for displaced/complex pediatric maxillofacial fractures.Results of this review suggest that titanium ORIF for maxillofacial fractures in the pediatric population is a reliable treatment. The surgeon must be committed to following these patients longitudinally. Interpreting the results should, however, be done with great care, as most articles have a medium to high risk of bias and limited follow-up.

Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study.

Background/AimsPaediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period.MethodsThe following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.ResultsBetween 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001).ConclusionThe main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.

A Better Way to Manage Paediatric Maxillofacial Trauma; A Retrospective Study Examining the Presentation of Maxillofacial Soft Tissue Injuries and Management over 3-year period at a Regional Children’s Hospital

Introduction: Maxillofacial treatment is evolving with changing paediatric lifestyles and clinical limitations, including COVID-19. The aim of this study is to assess trends in the presentation of maxillofacial soft tissue injuries and subsequent management within a regional paediatric hospital. Methods: Retrospective study over a 3-year period (from 2019-2021 between January and April). Inclusion of all paediatric patients seen on the emergency department by OMFS team. Results: Between 2019 and 2021, the total number of patients dropped by over half. The average age dropped from 5.9 in 2019 to 3.8 in 2021. Males were more commonly seen. Extraoral injuries increased by 21%. Intraoral injuries reduced by 8%. Less complicated communicating injuries and associated dental trauma were seen in 2021. Lip lacerations accounted for most injuries. In 2020, there was 21% reduction in conservative management of injuries. Wound closure under LA increased by 12% in 2020. There has been an overall increase in wound closure under GA by 5% between 2019 and 2020. Falls accounted for most injuries, however, there has been an increase in dog bite injuries by 5% in 2021. Conclusions: The average age has dropped between 2019-2021 and hence treatment options remain limited. Age, cooperation, and severity of injury are important factors. The number of overall lacerations has decreased but a greater proportion required formal closure under general anaesthesia. It is vital OMFS surgeons are aware of the changes in presentation and current trends in management. This will help to better equip surgical teams for the changing landscape of paediatric maxillofacial trauma. Introduction: Maxillofacial treatment is evolving with changing paediatric lifestyles and clinical limitations, including COVID-19. The aim of this study is to assess trends in the presentation of maxillofacial soft tissue injuries and subsequent management within a regional paediatric hospital. Methods: Retrospective study over a 3-year period (from 2019-2021 between January and April). Inclusion of all paediatric patients seen on the emergency department by OMFS team. Results: Between 2019 and 2021, the total number of patients dropped by over half. The average age dropped from 5.9 in 2019 to 3.8 in 2021. Males were more commonly seen. Extraoral injuries increased by 21%. Intraoral injuries reduced by 8%. Less complicated communicating injuries and associated dental trauma were seen in 2021. Lip lacerations accounted for most injuries. In 2020, there was 21% reduction in conservative management of injuries. Wound closure under LA increased by 12% in 2020. There has been an overall increase in wound closure under GA by 5% between 2019 and 2020. Falls accounted for most injuries, however, there has been an increase in dog bite injuries by 5% in 2021. Conclusions: The average age has dropped between 2019-2021 and hence treatment options remain limited. Age, cooperation, and severity of injury are important factors. The number of overall lacerations has decreased but a greater proportion required formal closure under general anaesthesia. It is vital OMFS surgeons are aware of the changes in presentation and current trends in management. This will help to better equip surgical teams for the changing landscape of paediatric maxillofacial trauma.

Epidemiologic analysis of pediatric maxillofacial trauma

BPurpose: This study aimed to analyze epidemiology and the treatment approaches for pediatric maxillofacial trauma patients who presented to the Department of Plastic, Reconstructive, and Aesthetic Surgery during 5 years period.&#x0D; Materials and Methods: Age and gender distributions of the patients were determined. Duration of hospitalization, etiology of trauma, location of the fracture, and treatment methods applied was determined, and the results of these treatments and complications that developed were evaluated.&#x0D; Results: The fractures were the most common at the age of 17 years (18.3%). The most common cause of trauma in patients operated for maxillofacial trauma was fall (48.3%). Most operations were performed in the age range of 12–17 years (50.6%), and panfacial fractures were the most frequently operated fracture localization (27.58%).&#x0D; Conclusion: The simplest and most effective treatment should be applied for pediatric maxillofacial trauma. While conservative treatments may be sufficient in minimally displaced fractures, open reduction and internal fixation methods are applied in fractures with greater displacement. Fixation materials must necessarily be removed since they prevent bone growth. The use of bioabsorbable plates has been limited in recent years due to their high costs.

Pediatric maxillofacial and dental trauma: A retrospective review of pediatric emergency management in Riyadh, Kingdom of Saudi Arabia

BackgroundDue to the high prevalence of oral and maxillofacial (OMF) trauma in city of Riyadh, a special focus on pediatric trauma is needed. The purpose of this audit was to assess the protocol followed by the OMF unit at King Khalid University Hospital (KKUH) on pediatric trauma patients. The trauma incidence, mechanism of injury, volume, the type of pediatric trauma operated and dental management were analyzed. Materials and MethodsA quantitative retrospective review of 223 patients, at pediatric emergency unit of KKUH, Riyadh, KSA from January 2017 to July 2018, was done. The data retrieved included variables such as, age, gender, and cause of injury, site of injury, type of injury, and assessment of jaws, and teeth. Data regarding the type of investigations, treatment protocol, follow up visit, and dental management, were extracted from the medical records. ResultsOf the 223 pediatric patients presenting to the emergency unit, 116 (52%) were under the age of 5 years. A total of 64.4% of patients reported “self-fall” as the cause of injury. Soft-tissue injuries were common in 63 (56.8%) of patients in the form of lacerations 87 (41.2%). Involvement of the teeth in the injury was observed in 57 patients, in which 33 (57.9%) patients were reported to have tooth/teeth avulsions, 15 (26.3%) patients had luxation and 9 (15.8%) patients had crown fractures. 27 (47%) patients were referred to the pedodontist for a follow-up visit. ConclusionsIt can concluded that clinicians facing maxillofacial trauma in an emergency department need to have access to useful and practice guidelines. The study also showed the need for more manpower-oriented training such as a pedodontist and a general dentist to join the OMFS team to manage pediatric patients. The regional referral hospitals should be equipped to decentralize the management of these patients to the Dental University Hospital.

Characteristics of pediatric maxillofacial fractures in Kuwait: A single-center retrospective study.

Pediatric maxillofacial fractures always present a challenge due to the unique nature of the facial skeleton anatomy and development. The aim of this study was to investigate the incidence, etiology, site of fracture, and management modalities of pediatric maxillofacial fractures in Kuwait. A retrospective cross-sectional study was conducted. The records of all pediatric patients who were diagnosed with maxillofacial fractures and admitted to one of the major hospitals in Kuwait between January 2007 and March 2020 were reviewed. A total of 186 patients aged between 0 and 13years old were included. An average of 13 patients was seen each year between 2007 and 2020. The leading cause of the pediatric maxillofacial trauma was road traffic accidents (RTA) that accounted for 38.2% of the patients followed by 22% falls from height (FFH). Male patients were more affected than females, with a ratio of 2.3:1. More than half of the children had mid-face fractures, of which 57% were in multiple sites. Conservative management was the main approach for 52.2% of the patients. Pediatric maxillofacial fractures were mainly attributed to road traffic accidents in Kuwait. Mid-face bone fractures were reported more than mandibular fractures and were mostly managed conservatively.

Maxillofacial Injury due to Pressure Cooker Explosion in a 13-year-old child: Surpassing The Obvious

Pediatric maxillofacial trauma is quiet commonly encountered in the pediatric emergency department. Management of pediatric maxillofacial trauma depends upon the cause and extent of the injury. Maxillofacial trauma due to the explosion of pressure cooker is rare in children. Here, we report a case of pediatric maxillofacial injury due to the explosion of pressure cooker in a domestic setting.

Management of Pediatric Maxillofacial Trauma Using Acrylic Cap Splint Followed by Circummandibular Wiring: A Single Centric Study

Introduction: Facial fractures in children account for 15% of all facial fractures in the general population. Children are more likely to have mandibular fractures than midface fractures, with condylar fractures being the most prevalent, followed by parasymphysis, angle, and body fractures. The low prevalence of mandibular fractures in children can be linked to the safe environment they are provided with as well as their unique growing patterns. Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning and in their functional needs. Materials and Methods: A prospective analysis of pediatric patients with mandibular symphysis/parasymphysis/body fractures operated from January 2016 to October 2021 was performed. Clinical photographs and orthopantomogram assessment at the time of presentation, after treatment, and at 6 months postoperatively were evaluated. Result: All 17 patients were followed up until the period of 6 months, and none of them had any major complications. Postoperatively, there was satisfactory healing and union of fracture fragments in all the patients. Only 1 patient developed an infection in the submental region. In each case, the surgical splint was removed during 15 to 21 postoperative days. The 6-month follow-up showed good occlusion, without interference in teeth eruption, and no signs of temporomandibular joint problems. Conclusions: In our study, because of the sheer ease of fabrication, maintenance of periodontal tissue integrity, patient compliance, and convenience of measuring the occlusion following reduction, we chose an acrylic cap splint followed by circummandibular wiring.

The association of weather, temperature, and holidays on pediatric maxillofacial trauma.

ObjectiveTo evaluate the association of weather, seasons, months and holidays on the frequency and pattern of pediatric facial fractures.MethodsRetrospective review of pediatric patients treated for facial fractures at two Level I trauma centers in a midsize Midwestern US city over a 5‐year period. Patients were included only if presentation was within 3 hours of inciting trauma, transfers from other facilities were excluded. Demographic characteristics, fracture patterns, operative interventions, weather data, and local public school schedules were acquired and associations were analyzed with unpaired t tests, χ2, multivariate and binomial regression model analyses.ResultsTwo hundred and sixty patients were included. The average age (SD) was 11.8 (5.0) years, with 173 males and 87 females. The highest distribution of presentations occurred in the summer season (35.0%), on weekends and holidays (58.1%), and when the weather was described as clear (48.5%). The most common mechanisms of injury were motor vehicle collisions (25.8%), followed by sports—(21.5%) and assault—(16.5%) related injuries. Mechanisms were significantly associated with certain fracture patterns. Older age was associated with fewer orbital fractures (P < .01). Seventy‐five patients (28.8%) required operative intervention. Age was found to impact the likelihood of operative intervention (Exp(β) = 1.081, P = .03) while weather, temperature, and mechanism did not.ConclusionPediatric facial fractures are linked to warmer weather with clear skies and warmer season. Age predicts some fracture patterns and need for operative intervention. These results can be used to inform public health interventions, policymaking, and trauma staffing.Level of Evidence: Level 2b (retrospective cohort).

Oral and maxillofacial injuries in children: a retrospective study.

ObjectivesThe purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population.Materials and MethodsData for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%.ResultsOf 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46).ConclusionFalls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.

Analysis of pediatric maxillofacial trauma in North China: Epidemiology, pattern, and management

PurposeTo analyze epidemiology, pattern, and management of pediatric maxillofacial trauma in North China. Patients and MethodsClinical records of patients aged 0–18 years with maxillofacial trauma, from January 2008 to December 2016 were reviewed. 390 patients with an average age of 9.8 ±5.8 years (range: 8 months–18 years) and a male:female ratio of approximately 2:1 were included in the study. Epidemiological features (age, sex, etiology), characteristics of injuries (locations, types, associated injuries), treatments, and complications were analyzed. ResultsAmong 55 patients with soft tissue injuries, palate was the most common site (32.7%). Among 335 fracture cases, the most common age group was 16–18 years (25.1%); falls was the main cause (38.2%). Overall, there were 450 fractures (1.78 per capita), primarily mandible (69.3%), followed by zygoma (12.9%), maxilla (7.7%) and other sites. Multiple fractures occurred in 61.5% of patients. The most common site of mandibular fractures was condyle. The proportion of mid-face fractures to mandibular fractures increased with age (p < 0.01) and stabilized gradually after 12 (approximately 1.14:1). 77.5% of fractures were treated surgically. There was an independent association of surgical intervention with age older than 6 years old (p < 0.05). Absorbable plates were mainly applied to mandibular fractures in patients aged 0–7 and only 1 was removed because of insufficient fixation strength. ConclusionsThe primary cause of pediatric maxillofacial fractures in North China was falls; traffic accidents led more multiple fractures and associated injuries. Palate and mandible were the most common sites of pediatric maxillofacial soft tissue injuries and fractures, respectively. The proportion of mandibular fractures to mid-face fractures decreased with the increase of age until 12.

Cervical Spine Injuries in Pediatric Maxillofacial Trauma: An Under-Recognized Problem.

Pediatric cervical spine injuries (CSI) are uncommon events, but can be devastating injuries. Facial fractures have been associated with injuries to the cervical spine in children, but may be deemed isolated facial fractures and bypass the standard trauma pathway. The objective of this study is to describe the mechanisms, associated injuries and outcomes of pediatric cervical spine injuries in patients with known maxillofacial trauma at a level 1 trauma center. An analysis was performed of all patients under the age of 18 with maxillofacial trauma admissions to a single level 1 trauma center, from 2006 to 2015. Patients were stratified based on the presence or absence of a cervical spine injury. Data was abstracted to include demographic, mechanism and clinical outcomes data. There were 1274 patients who were admitted with maxillofacial trauma during the study period. Of these, 72 (5.7%) experienced a cervical spine injury. Factors associated with cervical spine injuries include older age and penetrating mechanism. Cervical spine injuries were associated with concomitant traumatic brain injuries and skull fractures. Patients with spine injuries were more like to experience a longer length of stay and death. On multivariate analysis, only increased age predicted CSI. Our database demonstrated a 5.7% incidence of pediatric cervical spine injuries in patients with maxillofacial trauma. This incidence is higher than previously published reports of smaller cohorts. Clinicians must take care to stabilize the cervical spine in any patient with facial fractures, especially during work up and diagnostic maneuvers performed before spinal injuries are ruled out.

Pediatric Maxillofacial Trauma Management Experience at Tertiary Care Hospital- A Retrospective Study

ABSTRACT Objectives: To establish the etiology, pattern, management and outcome of maxillofacial trauma in pediatric patients. Study Design: Retrospective study. Setting and Duration: Department of Oral & Maxillofacial Surgery, Faisalabad Medical University, Faisalabad. January 2016 to January 2019. Materials and Methods: A three year record of pediatric patients who suffered from maxillofacial trauma was reviewed and analyzed using hospital database. The data gathered from the record of the patient’s like age which was presented as mean and standard deviation whereas data like gender, etiology of particular trauma, anatomic position of fracture, affiliated injuries, kind of treatment used and outcome of the treatment was presented as frequency and percentage. Results: Out of 135 pediatric maxillofacial trauma patients 91 (67.4%) were males and 44 (32.6%) were females making male to female ratio of 1.8:1. The mean age of the pediatric patients was 6.5 + 2.63 years. Fall was the most common etiology of the trauma 83 (61.5%) followed by RTA 40 (29.6%). Out of 157 different fracture types 113 (71.9%) occurred in mandible, and among mandible parasymphysis region was most commonly 42 (37.1%) fractured site. Majority of the patients were treated by ORIF 80 (59.3%). The concomitant injuries were observed in 31 (22.9%) patients and among these neuro-cranial injuries were most common in 19 (61.3%) patients. Post treatment complications were observed in 16 (11.9%) patients and among these limited mouth opening was the most commonly seen complication 8 (50%) patients. Conclusion: The results of this study verified pediatric male patient’s predominance. Mandible fracture was the most frequent site of pediatric maxillofacial trauma, predominantly caused by a fall. Majority of maxillofacial fractures were managed by open reduction and internal fixation. There is a need at a national level for a public, parent and teacher education program on child-care and safety.

Pediatric Maxillofacial Trauma Patterns Among Different Types of Road Traffic Accidents

Traffic accidents are one of the most leading cause of maxillofacial trauma. Defining the bone fracture patterns in different type of traffic accidents may enable for appropriate surgical approach. This study research the pattern of pediatric maxillofacial fractures in terms of different type of traffic road accidents and age groups. The data on road traffic accidents that caused maxillofacial trauma between May 2014 and January 2019 was gained from the University of Gaziantep hospital data system. Road accident type, age groups, and the type of fractures were the evaluation parameters. A total of 61 patients meet the criteria and 41 of those were boys. The midface bones of orbital, maxillar, and frontal are the most fractured structures with a total number of 48. The least fractured bone was mandibula with a number of 4. The comparisons of these fractures among the different type of road traffic accidents and age groups were found to be statistically significant. Car-pedestrian and car-passengers type of road traffic accident mostly seem to cause midface fractures at the primary and secondary school-aged children.

Pediatric maxillofacial trauma: epidemilogic study between the years 2012–2015 in Israeli medical center

Pediatric maxillofacial trauma: epidemilogic study between the years 2012–2015 in Israeli medical center