Facial Fractures in Children

Abstract

Fractures of the orbital roof are the most common facial fractures observed in pediatric patients after acute nonpenetrating trauma. Orbital roof and naso-orbital-ethmoid fractures are frequently associated with orbital hematomas and contiguous skull fractures.

A Naso-Orbito-Ethmoid (NOE) Fracture Associated with Bilateral Anterior and Posterior Frontal Sinus Wall Fractures Caused by a Horse Kick—Case Report and Short Literature Review

“…The most common causes of NOE fractures are motor vehicle collisions, followed by road traffic accidents and interpersonal violence, while fractures caused by horse kicks are extremely rare in the literature [11,12,13,14]. Due to the action of a high kinetic energy causative agent, NOE fractures are often associated with other fracture foci in the frontal bone, orbital walls, or midface [15,16,17]. In the present case, the injury caused by a horse kick was severe, inducing associated displaced comminuted fractures in the anterior and posterior walls of both frontal sinuses.…”

“…The treatment of NOE fractures is controversial, difficult, and varies depending on the type of fracture and the associated fracture lines [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Type I NOE fractures are treated by closed methods in the case of fragment stability after reduction, while type II and III fractures or NOE fractures associated with frontal bone fractures require open exposure of the operative field, with direct reduction and osteosynthesis fixation of the fractured fragments, obliteration or cranialization of the frontal sinuses, and in the case of MCT avulsion, the association of intraoperative canthopexy is mandatory [3,7,21,22,23].…”

“…This can be achieved using preformed titanium meshes, autologous bone grafts (calvaria, mandible, iliac crest, tibia, etc.) or combinations of these, depending on the pattern of the post-traumatic defect [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17]. Canthopexy can be performed by many methods, transnasal wiring currently being the method of choice [1,2,3,4,5,6].…”

Approach for naso-orbito-ethmoidal fracture

“…Approximately 60% of NOE fractures are associated with orbital fractures, and approximately 20% are diagnosed with panfacial fractures [9]. Isolated NOE fracture accounts for approximately 5% of all facial fractures in adults and 16% in pediatric facial fractures [10,11].…”

Supraorbital Blowin Fracture Presenting as an Ocular Dystopia in a Nine-Year-Old Girl

“…Generally speaking, pediatric orbital roof fractures are less likely to require surgical repair than their adult counterpart [24, 25]. Currently, there is no specific consensus on the treatment of orbital fractures in the pediatric population [26].…”