Malar and maxillary fractures among pediatric patients and the risk factors for mortality

Abstract

Background/Aims: No studies have characterized the morbidity and mortality of maxillary & malar fractures on a national scale. The aim of this study was to examine the risk factors for mortality in pediatric patients who had sustained maxillary and malar fractures by using a national pediatric hospital inpatient care database. Materials and methods:This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the cause of injury. The primary outcome variable was mortality rate. Additional predictor variables included age, gender, race, income, payer information, year and place of injury, number of facial fractures, concomitant facial fractures, other fractures of the body, and intracranial/ internal organ injury. Univariate and multivariate regression models were performed to assess risk factors for mortality. Statistical significance was set to a p-value <.05.Results: A total of 5859 patients met the inclusion criteria. The most common age group was 13-17 years of age (n = 3816, 65.1%). Motor vehicle accidents were the most common mechanism of injury (n = 2172, 37.1%). The presence of cranial vault (OR = 2.81, p = .017), skull base (OR = 2.72, p < .001), and vertebral column fractures (OR = 2.13, p = .016), as well as sub-arachnoid hemorrhage (OR = 4.75, p = .005), traumatic pneumothorax/hemothorax (OR = 2.16, p = .015), and heart/lung injury (OR = 3.37, p < .001) were each independently associated with increased odds of mortality.Conclusions: Patients in their late teens most commonly sustained malar and maxillary fractures, likely due to general trends in craniomaxillofacial development. The presence of other fractures located in close proximity to the mid-face increased the risk of mortality among pediatric patients with malar and maxillary fractures. This may be explained by the anatomical approximation of the mid-face to vital neurovascular structures of the head, which, when damaged, may prove fatal.

Pain management, pediatric dental injuries, and dental trauma education

“…14 Although several studies have been conducted regarding the prevalence of dental injuries in patients with facial fractures, there is a lack of homogeneity in the inclusion criteria such as etiology, incidence, and type of dental trauma. 16,17 In this Issue, Costantinides et al retrospectively analyzed and evaluated the incidence and associated factors of dental trauma in patients with maxillofacial fractures treated surgically. 18 The distribution and mechanisms of injuries were evaluated across age and gender in cases of facial fractures or dental trauma.…”

Predictive factors for maxillofacial fractures, sedentary behavior, and dental trauma literacy

“…Several studies report the potential complications of oral trauma in children and adolescents 1–3 . Maxillofacial fractures in pediatric populations can occur due to a variety of causes, including road traffic accidents, falls, violence, and sports 4 .…”