Midfacial fractures in pediatric patients. Frequency, characteristics, and causes.

OBJECTIVE: To determine the frequency, characteristics, and causes of midfacial fractures in children.

DESIGN: A retrospective review of the patients' medical charts and radiographs.

SETTING: Tertiary referral center.

PATIENTS: Fifty-four patients under 16 years of age, with midfacial fractures diagnosed and treated in the Helsinki (Finland) University Central Hospital from 1980 through 1992.

MAIN OUTCOME MEASUREMENTS: The data examined included sex, age, time and cause of the accident, type and location of the fractures, the presence and location of associated injuries, complications, and treatment methods.

RESULTS: The male-to-female ratio was 1.16:1. Motor-vehicle accident was the most common cause of injuries. The frequency of injuries was in decreasing order: (1) maxillary alveolar bone, (2) zygoma, and (3) Le Fort fractures of the maxilla. The majority of injuries occurred in subjects who were 13 to 15 years old. In children less than 6 years old, only alveolar fractures occurred. For the other age groups, no significant difference in the fracture pattern was found. No fatalities occurred in this patient series.

CONCLUSIONS: Midfacial pediatric fractures are rare. A high velocity force, such as that from a motor-vehicle accident is a factor producing the injury. Owing to the high impact, associated injuries are common. The severity of the insult is more essential than the age of the patient and the development of the paranasal sinuses.