A retrospective study of causes, management, and complications of pediatric facial fractures

Abstract

Objectives: The objective of this study was to report causes, management options, and complications of facial fractures among children.

Materials and methods: The groups were defined on the basis of age, gender, cause of injuries, location, and type of injuries. The treatment modalities ranged from no intervention, closed reduction alone or with open reduction internal fixation (ORIF).

Statistical analysis: Descriptive statistics were generated by using SPSS software for the entire range of the variables under study.

Results: Records of 240 pediatric patients were obtained and a total of 322 fractures were found among a study sample. Among these, one-thirds were due to road traffic accidents (RTAs) (37.26%) and fall injuries (36.64%), making them the leading causes of facial fractures. Mandibular fractures were the most common and they accounted for 46% (n = 148) of all fractures. The highest number of RTA (n = 27) was found in adolescents and fall injuries were more prevalent in preschool children (n = 34). Forty-two percent of the fractures (n = 101) were treated with close treatment using arch bars and splints, followed by ORIF (n = 68). The rest, 29.6% (n = 71), received conservative treatments. Postoperative complications were observed in 18.33% (n = 44) of cases, of which jaw deviation, growth disturbance, and trismus were more frequently encountered.

Conclusion: Pediatric facial fractures if not managed properly can cause severe issues; therefore, injury prevention strategies should be strictly followed to reduce pediatric injuries in low socioeconomic countries.

Keywords: Complications; facial fractures; fall injuries; road traffic accident; surgical fixation.

Figure 1

(a) Bilateral periorbital ecchymosis and subconjunctival hemorrhage, depressed nasal bridge, telecanthus, and chin laceration, (b) X-ray paranasal sinus view showing bilateral Lefort fracture lines, mandible symphysis, and nasoorbitoethmoidal fractures

Figure 2

Massive periorbital and facial edema with bilateral periorbital ecchymosis, stitched nasal bridge, and left upper lid

Figure 3

Arch bar and elastics, healing scar at right chin