MIDFACIAL FRACTURES IN PEDIATRIC-PATIENTS - FREQUENCY, CHARACTERISTICS, AND CAUSES

Objective: To determine the frequency, characteristics, and causes of midfacial fractures in children. Design: A retrospective review of the patients' medical charts and radiographs. Setting: Tertiary referral center. Patients: Fifty-four patients under 16 years of age, with midf acial fractures diagnosed and treated in the Helsinki (Finland) Univer sity Central Hospital from 1980 through 1992. Main Outcome Measurement s: The data examined included sex, age, time and cause of the accident , type and location of the fractures, the presence and location of ass ociated injuries, complications, and treatment methods. Results: The m ale-to-female ratio was 1.16:1. Motor-vehicle accident was the most co mmon cause of injuries. The frequency of injuries was in decreasing or der: (1) maxillary alveolar bone, (2) zygoma, and (3) Le Fort fracture s of the maxilla. The majority of injuries occurred in subjects who we re 13 to 15 years old. In children less than 6 years old, only alveola r fractures occurred. For the other age groups, no significant differe nce in the fracture pattern was found. No fatalities occurred in this patient series. Conclusions: Midfacial pediatric fractures are rare. A high velocity force, such as that from a motor-vehicle accident is a factor producing the injury. Owing to the high impact, associated inju ries are common. The severity of the insult is more essential than the age of the patient and the development of the paranasal sinuses.