Traumatic skull fractures in children and adolescents: A retrospective observational study

Wang, Hongwei; Zhou, Yue; Ou, Lan; Han, Jing; Xiang, Liangbi

doi:10.1016/j.injury.2017.11.039

Cited by 16 publications

(9 citation statements)

References 32 publications

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“…1,2 Different countries with different culture, and daily activities presented with different patterns of fractures. [3][4][5][6][7][8] Some specific fracture sites had an increasing incidence in pediatric patients, 9,10 but data on the patterns and epidemiologic trends of traumatic facial fractures in China are scarce. Compared with facial fractures occurring in adults, traumatic facial fractures in children and adolescents are relatively uncommon.…”

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Traumatic Facial Fractures in Children and Adolescents

Wang

Song

Ren

et al. 2018

Journal of Craniofacial Surgery

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This study showed a retrospective analysis of the incidence and pattern of traumatic facial fractures in a pediatric and adolescent population ( 18 years old) in China. The authors retrospectively reviewed 154 children and adolescent who had traumatic facial fractures and who were admitted to our university-affiliated hospitals from 2005 to 2010. This study enrolled 109 males and 45 females aged 11.9 AE 5.2 years old. The incidence peaked around the periods of 12 to 18 years in the male, 6 and 16 to 18 years in the female. The most common etiologies were motor vehicle collisions (MVCs) (60, 39.0%), followed by high fall (40, 26.0%), low fall (32, 20.8%). The most common fracture sites were mandible (78, 50.6%) and nose (33, 21.4%), followed by orbit (31, 20.1%). A total of 35 (22.7%) patients suffered neurological deficit. The patients in the 12 to 18 age range group accounted for the largest proportion of 54.5%. Fracture incidence showed peaks between the hours of 12:00 to 16:00 PM (33.7%), during the autumn season (30.5%) and on Friday to Sunday (50.0%). The most common etiology and fracture site were MVCs and mandible, respectively. Etiologies and patterns of traumatic facial fractures vary with age. Continued efforts toward injury prevention of traumatic facial fracture among the children and adolescents are warranted.

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Traumatic Facial Fractures in Children and Adolescents

Wang

Song

Ren

et al. 2018

Journal of Craniofacial Surgery

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“… 2) In this respect, 4% of all patients with severe head injuries suffer from BSF, accounting for 19–21% of skull fractures. 7) The incidence of these fractures was 3.5–24% in Asian studies, while previous studies in Nigeria indicated a higher incidence of 33–46%. 9) …”

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confidence: 93%

Basilar Skull Fractures and Their Complications in Patients With Traumatic Brain Injury

Shafiei

Aminmansour

Mahmoodkhani

et al. 2023

Korean J Neurotrauma

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Objective Since traumatic brain injury is more common in young people, who are the main workforce and builders of society, it is important to consider the effects caused by brain injury on them. In this study, we investigated the clinical manifestations, complications, and prognosis of patients with basilar skull fractures. Methods This cross-sectional study was conducted from March 2021 to March 2022 at the Kashani Hospital, Esfahan, Iran. Patients with basilar skull fractures were included in this study by census for one year. Recorded patient information was divided into two parts: demographic information, including age and sex, and disease information including loss of consciousness, signs of meningitis, need for surgery, and neurologic examination. Results In this study, 100 patients were included, of whom 89 were men. The most common complication was pain at the site of the trauma, followed by bruising and bleeding from the site of the trauma. Raccoon eyes and cerebrospinal fluid leakage were observed in 19% and 32% of the patients, respectively. Conclusion As the occurrence of trauma has an economic burden on the country's health system, we must identify its consequences and problems and prevent its occurrence as much as possible by implementing educational measures.

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“…The high prevalence of skull, orbital, and midface fractures in the ICU group are likely due to the high-impact mechanism of injury documented in patients presenting with these fractures. [10][11][12][13] Conversely, the lower proportion of mandibular fracture patients admitted to the ICU may be due to anatomic factors, such as location lower in the face and wide range of presentations (eg, isolated condylar fracture vs bilaterally displaced ramus fractures). While patients with mandibular fractures had high rates of musculoskeletal (44.7%), respiratory (36.2%), dental (25.5%), and ophthalmologic injuries (23.4%), they may have a wider range of severity, with less severe mandibular fractures occurring more frequently.…”

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confidence: 99%

Characteristics of Facial Fractures in Critically Injured Children

Irgebay

Mehta

Beiriger

et al. 2022

FACE

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Background: Treatment of facial fractures in pediatric patients requiring intensive care unit (ICU) care has not been well categorized. The purpose of this study is to describe a single-institution experience with the management of pediatric facial fractures in patients requiring ICU-level care. Methods: We performed a retrospective review of patients under 18 years old who presented to a level I trauma center with facial fractures between 2006 and 2021. Types of facial fractures, mechanisms of injury, operative treatment, GCS score, and associated injuries were evaluated in ICU patients compared to patients who were admitted to the hospital, but not ICU. Results: Facial fractures were diagnosed in 3334 patients. Of them, 1080 were admitted to the hospital and 207 patients (19.2%) required ICU-level care. Among these patients, the average age was 9.7 ± 4.9 years. The average length of stay was 9.2 ± 10.9 days and the average lowest GCS score was 10.3 ± 4.6. The most common mechanism of injury was a motor vehicle accident (n = 122, 59.5%). Compared to non-ICU admitted patients, patients admitted to the ICU were significantly more likely to present with skull (n = 124, 60.5%, P < .001), orbital (n = 140, 68.3%, P < .001), and maxillary fractures (n = 96, 46.8%, P < .001) and significantly less likely to present with mandibular fractures (n = 47, 22.9%, P = .020). ICU patients had significantly more associated injuries, particularly neurological injuries (91.2% vs 47.8%, P < .001). ICU patients underwent operative treatment at the same rate as non-ICU admitted patients (OR, 0.7 [95% CI, 0.5-1.0]). Conclusions: Pediatric facial fracture patients requiring ICU-level care are a poorly characterized population. Our data suggest that high impact mechanisms of injury and specific fracture patterns are associated with ICU admission as these patients require particular attention and management.

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Traumatic skull fractures in children and adolescents: A retrospective observational study

Cited by 16 publications

References 32 publications

Traumatic Facial Fractures in Children and Adolescents

Traumatic Facial Fractures in Children and Adolescents

Basilar Skull Fractures and Their Complications in Patients With Traumatic Brain Injury

Characteristics of Facial Fractures in Critically Injured Children

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