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Pediatric Facial Fractures in Patients with Autism Spectrum Disorder
Anne E. Glenney, BA1; Zhazira Irgebay, BA 1; Meeti Mehta, BS 2; Janina Kueper, MD3; John Smetona, MD 1; Justin Schreiber, MD4; Joseph E. Losee, MD1; Jesse A. Goldstein, MD 1
UPMC
2023-01-31
Presenter: Anne E. Glenney, BA
Affidavit:
Vu Nguyen
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Craniofacial fractures are understudied and poorly characterized in patients with Autism Spectrum Disorder (ASD). This study presents demographic, diagnostic, and treatment data on pediatric facial fracture patients with ASD.
Methods: A retrospective review was performed of patients with craniofacial fractures under 18 years of age who presented to a pediatric level I trauma center from 2006 to 2021. Data collected included demographics, injury details, associated injuries, management, outcomes, and ASD status.
Results: Facial fractures were diagnosed in 3334 patients; 30 had a diagnosis of ASD. Average age was 12.0 ą 4.8 years; most were white (90.0%) and male (93.3%). Eleven patients had a concomitant ADHD diagnosis (36.7%) and 12 (40.0%) had previous neurological disorder diagnoses. The most common mechanisms of injury were violence (n = 9, 30.0%) and activities of daily living (n = 8, 26.7%). Nasal fracture was the most common fracture (n = 24, 77.4%). ASD patients were less likely to present with orbital fractures (9.7% vs 26.2%, p <0.037), but there was no difference in rates of maxillary, nasal, or mandibular fractures. Odds of receiving operative treatment were lower in patients on the autism spectrum (OR: 0.4; CI 95%, 0.2-0.8); however, there was no difference in admission rates between groups (25.8% vs 32.5%, p = 0.431).
Conclusions: Pediatric facial fractures in ASD patients are poorly characterized. Our study describes the unique characteristics of this understudied population. Our results demonstrate similar patterns of facial fractures compared to controls; however, ASD patients were less likely to receive operative treatment.
