(73) Facial Trauma in Children

Abstract: Facial fractures are moderately uncommon in children in comparison with adults, despite facial trauma being common in pediatric population, with most cases involving soft tissues or dentoalveolar structures. Facial fractures can, however, be associated to extreme injury and cause critical condition. In pediatric facial fractures, skeleton must be managed attentively considering the psychosocial, anatomical, growth and functional differences. The handling is relatively more conservative than that of adults, to prevent the disruption of future growth and development. A nonsurgical approach whenever possible is preferred. The aim of this study was to evaluate the etiology, pattern, and tissue injuries in facial trauma in children through an observational, descriptive and transversal study involving patients who were cared in the emergency room of a hospital in Rio Grande do Sul, Brazil. Data were collected from January 2016 to December 2023, in alternate days, considering sociodemographic and trauma related variables with descriptive analyses to data. The total number of patients attended in this period of time was 1,401, from which 189 (13.5%) were 0-11 years old. From these ones, 122 (64.5%) were male and the average age was 5.3. The most prevalent trauma was falling (59%-31.2%), followed by high-level falling (36%-19%), bicycle fall (29%-15.3%), and pranks (20%-10.6%). There were 163 (86.2%) children with soft tissues lesions and 52 (27.5%) with facial bone fractures. What most affected children was dentoalveolar fracture with 49 (25.9%) cases, following tooth fracture with 14 (7.4%) cases. It can be concluded that children are not an age group that is highly affected by facial trauma, being the most prevalent etiology the falls, high-level falls, bicycle collapse, and playing, common in this age group. We also concluded that fractures in children are rare, and despite there being injuries to soft tissues, bone fractures do not occur, which can be justified by the greater amount of soft tissue in children. Finally, parents should be aware of dental and alveolar trauma and, when necessary, seek help from an oral and maxillofacial surgeon and/or a pediatric dentist.
References
Gupta K, Verma N, Katiyar A, Gaur S, Gupta S, Pandey M. A stitch in time saves nine: All about pediatric facial fracture. Natl J Maxillofac Surg 2022;13:27-31.
Lim RB, Hopper RA. Pediatric Facial Fractures. Semin Plast Surg 2021;35:284–291. DOI https://doi.org/ 10.1055/s-0041-1736484. ISSN 1535-2188.