A Clinical Analysis and Appropriate Management of Pediatric Facial Bone Fractures: 6 Years Survey

Oh, Jung Keun; Kim, Ing Gon

Abstract

As significant increase in the pediatric accidents becomes socially and morally concerned, reviewing over the statistical analysis of the pediatric accidents was needed especially in their facial bone traumas, in order to deduce a preventive and so to speak, protocols of treatments. This retrospective study comprise 73 pediatric patients who sustained facial bone fractures through various accidents and treated in the department of Plastic and Reconstructive Surgery, Seoul Hospital, Hanyang Medical Center during past 6 years from January 1993 to December 1998. The medical records of these 73 patients (91 fractures) were reviewed and analyzed retrospectively in order to obtain the clinical pattern and understand the therapeutic modalities. The statistical items were the prevalent time, age, sex and cause distribution, fracture sites, accompanying injuries, intervals among accident, arrival and operation, treatment methods with fixation materials, and complications were reviewed as following results. An increment of 5.1% per year of pediatric facial bone fractures was noted where 5.4% reduction of the population during the same periods. The mean age of patients was 10.5 years and the range of age was 3 to 15 years with males predominating over females in 3.1:1 ratio as in 3.5:1 in adults. Traffic accidents(43.9%) were responsible for the majority of facial bone fractures followed by violence(26.4%), fall(18.7%) and 91 facial fractures in 73 patients were classified where most common sites were nasal bone (56.1%) followed by blow-out fracture excluding other orbital fractures(17.6%), mandible(15.4%), zygoma(5.5%), orbital rim(2.2%), maxilla (2.2%) and frontal sinus(1.1%). Associated soft tissue injuries were combined in 52 patients(71.2%) and fractures other than facial bone were developed in 12 patients (16.4%) and treatment for facial bone fracture consisted of open reduction(40.6%), closed reduction(54.9%) and conservative treatment(5.5%). The complication rate was 9.4% and the most common complication was local infection followed by ophthalmologic problems and facial asymmetry. All data were analyzed based on the charts, medical records, and X-ray findings and presentation of the goals and optimal course of the entire management was made.