Maxillofacial trauma in children: Association between age and mandibular fracture site

Cleveland, Chelsea N; Kelly, Andrew P.; DeGiovanni, Jason C; Ong, Adrian A.; Carr, Michele M.

doi:10.1016/j.amjoto.2020.102874

Cited by 27 publications

(35 citation statements)

References 37 publications

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“…The highly vascularized condyle and its thin neck are susceptible to low-velocity trauma such as falls. 24,28,49 On the contrary, the nasal bones are the most susceptible in the facial skeleton, a factor that is associated with their relative prominence on the face, rendering this site more prone to injury with older age. 30,31 Because of problems associated with interference with the growth and development of the facial skeleton, as well as with normal dental development, a minimalist approach (no treatment or closed reduction) is often the preferred management for maxillofacial fractures, especially of the mandibular condyle, in preschool and school age children.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study

Segura‐Pallerès

Sobrero

Roccia

et al. 2022

Dental Traumatology

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Background/Aims Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period. Methods The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001). Conclusion The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.

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Section: Discussionmentioning

confidence: 99%

Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study

Segura‐Pallerès

Sobrero

Roccia

et al. 2022

Dental Traumatology

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“…While it is less than 1% below the age of 5, this figure may be as high as 14% around the age of 16. A recent retrospective study showed that approximately one-third of children with facial fractures may have a skull base fracture as well and that mandibular symphysis is the most common affected site 4. Infant mandibular fractures only represent 0.9%–2.4% of the paediatric facial cases.…”

Section: Discussionmentioning

confidence: 99%

Symphyseal fracture in a three-month-old infant

Labib

Elbarbary

2021

BMJ Case Rep

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Mandibular fractures are rare in infants, and diagnosis can be easily missed due to the difficulty in obtaining an adequate history and the subtle signs. A high index of suspicion and detailed history taking from the caregiver are mandatory to pick up these cases.There are a plethora of management options that have been reported in dealing with such fractures. They range from conservative management to internal fixation by absorbable plates. While conservative management does not interfere with mandibular growth and teeth development, any surgical intervention can carry this risk. Nevertheless, a severely displaced fracture may need anatomical reduction and fixation to allow early nutrition.This study reports a 3-month-old male infant with a fracture in the mandibular symphysis who underwent reduction of the fracture and circummandibular fixation using immobilisation by an acrylic splint for 4 weeks. His long-term follow-up after 20 months showed adequate dentition with proper healing of the fracture site.

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“…9B). 34,35 In some cases, a large inferior border plate on the lateral border, coupled with a shallow vestibule may make wearing a denture less feasible. In these circumstances, placement of the reconstruction plate on the underside of the mandible, with screws oriented vertically or near vertically, may allow a patient to continue to wear a denture.…”

Section: Special Populations Atrophic Mandiblementioning

confidence: 99%

“…The next most common are symphysis and parasymphysis fractures. [36][37][38] Body fractures are relatively rare. [39][40][41] Management must take into account eventual mandibular growth, presence of tooth buds, and eruption of permanent teeth.…”

Section: Mandibular Injuries In Childrenmentioning

confidence: 99%

Mandibular Fractures: Diagnosis and Management

Panesar

Susarla

2021

Semin Plast Surg

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Accurate evaluation, diagnosis, and management of mandibular fractures is essential to effectively restore an individual's facial esthetics and function. Understanding of surgical anatomy, fracture fixation principles, and the nuances of specific fractures with respect to various patient populations can aid in adequately avoiding complications such as malocclusion, non-union, paresthesia, and revision procedures. This article reviews comprehensive mandibular fracture assessment, mandibular surgical anatomy, fracture fixation principles, management considerations, and commonly encountered complications. In addition, this article reviews emerging literature examining 3-dimensional printing and intraoperative imaging.

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Maxillofacial trauma in children: Association between age and mandibular fracture site

Cited by 27 publications

References 37 publications

Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study

Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study

Symphyseal fracture in a three-month-old infant

Mandibular Fractures: Diagnosis and Management

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