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Demographics, Injury Patterns, and Associated Injuries in 3,334 Pediatric Facial Fracture Patients Treated at a Single Institution
Anne E. Glenney, BA1; Zhazira Irgebay, BA1; Erin Anstadt, MD1; Lucas A Dvoracek, MD1; Joseph W. Mocharnuk, BA1; Justin W. Beiriger, BSE1; John Smetona, MD1; Richard A. Saladino2, MD; Joseph E. Losee, MD1; Jesse A. Goldstein, MD1
University of Pittsburgh Medical Center (UPMC)
2023-01-30
Presenter: Anne E. Glenney
Affidavit:
Vu Nguyen
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Pediatric craniofacial fractures are fundamentally distinct from their adult counterparts due to unique injury patterns and effect on future growth. Understanding patterns and injury context informs management and risk mitigation. Previous studies include only inpatients, operative patients, or are specialty-specific, while this study presents a comprehensive assessment of all pediatric facial fracture patients seen at a single institution.
Methods: Patients under 18 years old who were evaluated for facial fractures at a Level I pediatric trauma center between 2006 and 2021were reviewed. Sub-analysis was performed for groups defined by age. Variables studied included demographics, etiology, fracture pattern, associated injuries, management and outcomes.
Results: 3,334 patients were included. Mean age at presentation was 11.5 years. The majority were Caucasian (82.6%) and male (68.4%). Sports were the leading cause of injury in older patients (42.2% of patients over 12 years), compared to activities of daily living in patients under 6 years (45.5%). Thirty-two percent of patients were hospitalized, 6.0% required ICU care, and 48.4% required surgery. Frequency of ICU admission decreased with age (p<0.001), while operative intervention increased with age (p<0.001). Zygomaticomaxillary complex (p=0.002) and nasal fractures (p<0.001) were common in older patients, while younger patients experienced more skull (p<0.001) and orbital fractures (p<0.001). The most common associated injuries were soft tissue (55.7%) and neurologic (23.6%).
Conclusions: This large-scale study provides updated characterization of craniofacial fractures in the pediatric population, providing a necessary framework for future studies on outcomes assessments and preventative care.
