PEDIATRIC FACIAL FRACTURES - A DEMOGRAPHIC-ANALYSIS OUTSIDE AN URBAN-ENVIRONMENT

This study reviews all pediatric facial fractures treated operatively at the C.S. Mott Children's Hospital of the University of Michigan ove r a 5-year period. Previous series of pediatric facial fractures have been collected at large urban centers and may not be representative of all practice environments, Our institution is a level 1 trauma center that serves a patient population primarily from suburban and rural re gions throughout the state, Referral and practice patterns at our inst itution gave us an important opportunity to analyze differences in pat ient care and management secondary to venue, and challenge the assumpt ions made by studies collected at large urban centers. We reviewed 80 fractures in 62 patients, Patient age ranged from 2 to 18 years old wi th the majority of patients (58%) between 15 and 18 years old. Most fr actures resulted from motor vehicle accidents (43%) and there were no firearm injuries. Fracture sites included the mandible (38%), the fron tonasoethmoid region (35%), the midface (17%), and the orbit (10%). On ly two operative complications were reported, There were no cervical s pine injuries, Median patient age was higher and mechanism of injury d iffered in our study compared with urban studies. Rapid changes in the health care delivery system and the emergence of managed care demand accurate demographic updates for the efficient allocation of valuable resources. Our results showed important differences with previous stud ies and imply that assumptions and analysis of the care of pediatric f acial fractures based solely on data collected at large urban centers may be too parochial, and therefore subsequent health care decisions o f resource allocation arrived at without respect to practice environme nt could be erroneous.