Epidemiological Patterns and Clinical Management Strategies of Pediatric Facial Fractures
,
Abstract
Introduction: Pediatric maxillofacial fractures pose unique challenges due to anatomical and developmental differences from adults. Effective management requires understanding the etiology, patterns, and treatment of these injuries. To evaluate the incidence, causes, types, and treatment of pediatric facial fractures, aiming to improve clinical management and preventive strategies. Materials and Methods: A cross-sectional study was conducted on 100 children (aged <15 years) with facial fractures at Shar Teaching Hospital, Sulaimani, Iraq, from October 10, 2024, to April 20, 2025. Data on demographics, causes, fracture types, associated injuries, and treatment methods were analyzed. Results: The study population had a mean age of 7.85 years, with 65% of the participants being male. Falls were the most common cause (59%), followed by road traffic accidents (38%). Lower facial fractures (53%) were most frequent, primarily involving the mandible, followed by mid facial (50%) and upper facial fractures (1%). Soft tissue injuries occurred in 90% of cases, and 11% had additional orthopedic or neurological injuries. Treatment methods included closed reduction (47%), conservative management (44%), and open reduction (9%). Conclusion: Pediatric facial fractures are more common in males and older children, primarily caused by falls and road traffic accidents. Improved safety measures, enhanced parental supervision, and specialized pediatric trauma management are essential. Large-scale studies are needed to establish standardized treatment protocols. Keywords: Pediatric facial fractures; Maxillofacial trauma; Fracture patterns; Injury prevention; Trauma management.
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5. Mulinari-Santos, G., Santana, A. P., Botacin, P. R., & Okamoto, R. (2024). Addressing the Challenges in Pediatric Facial Fractures: A Narrative Review of Innovations in Diagnosis and Treatment. Surgeries, 5(4), 1130-1146.
6. Ferreira, PC, et al. (2004) Etiology and patterns of pediatric mandibular fractures in Portugal: a retrospective study of 10 years. J Craniofac Surg; 15 (3): 384-391.
7. Juncar, R. I., Țenț, P. A., & Juncar, M. (2023). Clinical Patterns and Treatment of Pediatric Facial Fractures: A 10-Year Retrospective Romanian Study. Children, 10(5), 800.
8. On, S.-W.; Park, S.-Y.; Yi, S.-M.; Park, I.-Y.; Byun, S.-H.; Yang, B.-E. Current Status of Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) in Maxillofacial Surgery: Should It Be Continued? Bioengineering 2023, 10, 1005.
9. De Alencar Gondim, DG, et al. (2015) Pediatric facial fractures: case series and critical review. International Archives of Medicine; 8.
10. Al-Qudah, M. A., & Bataineh, A. B. (2023). Pattern and management of maxillofacial fractures in Jordanian children and adolescents. Medicina Oral, Patología Oral y Cirugía Bucal, 28(3), e272-e278.
11. Maliska, M. C. S., Lima Júnior, S. M., & Gil, J. N. (2013). Analysis of 185 maxillofacial fractures in the state of Santa Catarina, Brazil. Brazilian Oral Research, 27(4), 300-305.
12. Juncar, R. I., Moca, A. E., Juncar, M., Moca, R. T., & Țenț, P. A. (2023). Clinical Patterns and Treatment of Pediatric Facial Fractures: A 10-Year Retrospective Romanian Study. Children, 10(5), 800.
13. Choi Y, Lee HJ, Kang DH, et al. Epidemiology of violence in pediatric and adolescent nasal fracture. Arch Craniofac Surg. 2019;20(4):235-240.
14. Dong SX, Shah N, Gupta A. Epidemiology of Nasal Bone Fractures. Facial Plast Surg Aesthet Med. 2022;24(1):24-28.
15. Rahman, RA, et al. (2007) Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals. Int J Pediatr Otorhinolaryngol; 71 (6): 929-936.
16. Rottgers, SA, et al. (2011) Outcomes in pediatric facial fractures: early follow-up in 177 children and classification scheme. J Craniofac Surg; 22 (4): 1260-1265.
17. Kim SH, Han DG, Shim JS, Lee YJ, Kim SE. Clinical characteristics of adolescent nasal bone fractures. Arch Craniofac Surg. 2020;21(1):50-54.
18. Kaban LB, Mulliken JB, Murray JE. Facial fractures in children: An analysis of 122 fractures. Plast Reconstr Surg. 2020;146(3):435-443.
19. Patel J, McGuire E, Cray J, et al. Pediatric facial fractures: Demographics, treatment trends, and comparative outcomes. J Oral Maxillofac Surg. 2019;77(9):1831-8.
20. Posnick JC, Goldstein JA, Sanghavi P. The effects of pediatric mandibular fractures on growth and form. Plast Reconstr Surg. 2020;145(1):167-176.
21. Haug, RH and Foss, J (2000) Maxillofacial injuries in the pediatric patient. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology; 90 (2): 126-134.
22. Erdmann, D, et al. (2008) A retrospective analysis of facial fracture etiologies. Annals of plastic surgery; 60 (4): 398-403.
23. Ferreira, PC, et al. (2005) Retrospective study of 1251 maxillofacial fractures in children and adolescents. Plastic and reconstructive surgery; 115 (6): 1500-1508.
24. Grunwaldt, L, et al. (2011) Pediatric facial fractures: demographics, injury patterns, and associated injuries in 772 consecutive patients. Plastic and reconstructive surgery; 128 (6): 1263-1271.
25. Kauke M, Wolf M, Rammler K, et al. Bleeding control in maxillofacial trauma: New strategies and evidence. World J Emerg Surg. 2023;18(1):35.
26. Sato FRL, Asprino L, de Moraes M, et al. Epidemiological analysis of maxillofacial fractures in Brazil: A 10-year study. Int J Oral Maxillofac Surg. 2022;51(3):301-308.
27. Al-Azzawi ZS, Al-Saffar ZA, Al-Dawoody BS. The pattern of maxillofacial fractures in Iraq: A cross-sectional retrospective study. J Oral Maxillofac Surg. 2023;81(1):51-58.
28. Reeves TE, Rogers GF. Pediatric facial fractures. Clin Plast Surg. 2022;49(3):459-74.
29. Mulinari-Santos G, Paino Santana A, Botacin PR, Okamoto R. Addressing the Challenges in Pediatric Facial Fractures: A Narrative Review of Innovations in Diagnosis and Treatment. Surgeries. 2024;5(4):1130-1146.
30. Pan Y, Zhu H, Hou L. Epidemiological analysis and emergency nursing care of oral and craniomaxillofacial trauma: a narrative review. Ann Palliat Med. 2022;11(5):1879-1891.
31. Follmar KE, Debruijn M, Baccarani A, Bruno AD, Mukundan S Jr, Erdmann D, Marcus JR. A 10-year retrospective study of pediatric facial fractures: clinical characteristics, management, and outcomes. Plast Reconstr Surg. 2023;151(2):345-354.
32. Hopper RA, Sze RW. Pediatric facial fractures. Clin Plast Surg. 2022;49(3):459-74.
33. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer H. Craniomaxillofacial trauma: A 10-year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg. 2022;50(5):420-6.
34. Zachariades, N, Papavassiliou, D and Koumoura, F (1990) Fractures of the facial skeleton in children. J Craniofac Surg; 18 (4): 151-153.
35. Stylogianni, L, Arsenopoulos, A and Patrikiou, A (1991) Fractures of the facial skeleton in children. Br J Oral Maxillofac Surg; 29 (1): 9-11.
36. Oji, C (1999) Jaw fractures in Enugu, Nigeria, 1985-95. Br J Oral Maxillofac Surg; 37 (2): 106-109.
37. Koch BL. Pediatric considerations in craniofacial trauma. Neuroimaging Clin N Am. 2014;24(3):389-400.
38. Kang DH, Song WC, Lee JH, et al. Epidemiology and treatment outcomes of pediatric facial fractures: a 5-year retrospective study. J Korean Assoc Oral Maxillofac Surg. 2021;47(1):27-34.
39. Zhang X, Dong Y, Wang X, et al. Characteristics and treatment of pediatric maxillofacial fractures in China: a retrospective study of 8 years. J Craniofac Surg. 2021;32(5):e451-e455.
40. Almasri MA. Epidemiology and pattern of pediatric maxillofacial fractures in a tertiary hospital in Saudi Arabia: a retrospective study. Saudi Med J. 2020;41(3):296-301.
41. Sakamoto Y, Yotsuyanagi T, Yamauchi M, et al. Pediatric facial fractures: a 16-year retrospective study. J Plast Reconstr Aesthet Surg. 2021;74(3):644-651.
42. Kazi N, Ranadive P, Rajurkar S, Sharma A, Deshpande M, Ingole S. Epidemiology of maxillofacial trauma in pediatric and adolescent population: an institutional experience of 6 years. Open J Orthop. 2022;12(6):277-287.
43. Schild S, Puntarelli TR, delaPena M, Johnson A, Butts SC. Facial Soft Tissue Injuries in Pediatric Patients. Facial Plast Surg. 2021;37(4):516-527.
44. Patidar, D., Sogi, S., Fry, R.R., Patidar, D.C., & Malhotra, A. (2023). Maxillofacial Trauma in Pediatric Patients: A Retrospective Study. Journal of Maxillofacial and Oral Surgery, 23, 99–106.
45. Scariot, R, Oliveira, IAd, Passeri, LA, Rebellato, NLB and Muller, PR (2009) Maxillofacial injuries in a group of Brazilian subjects under 18 years of age. J Appl Oral Sci; 17 (3): 195-198.
46. Mokoena T, Lalloo R, Khammissa RAG, Wood NH, Lemmer J, Feller L. The epidemiology and management of traumatic facial fractures in children seen in a tertiary hospital in Johannesburg, South Africa. S Afr Dent J. 2019;74(7):318-323.
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| Files | ||
| Issue | Vol 12, No 1 (Winter 2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Pediatric facial fractures; Maxillofacial trauma; Fracture patterns; Injury prevention; Trauma management. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mahmood Faris B, Zangana M, Gataa I. Epidemiological Patterns and Clinical Management Strategies of Pediatric Facial Fractures. J Craniomaxillofac Res. 2025;12(1):7-16.
