Skip to main content
SpringerLink
Log in

Pediatric Facial Fractures

  • Chapter
  • First Online:
Book cover Ferraro's Fundamentals of Maxillofacial Surgery

  • 3546 Accesses

Abstract

The treatment of pediatric facial fractures can be challenging, stimulating, and occasionally frustrating, especially for those practitioners who only rarely manage these injuries. Difficulties arise from the fact that unlike their adult counterparts, no standardized protocols exist for the management of pediatric facial fractures; there are only broad guidelines and rare case reports. When evaluating a pediatric facial trauma patient, it should be remembered that the same fracture pattern will rarely be seen in a 5-month-old, a 5-year-old, and a 15-year-old due to the inherent differences in craniofacial anatomy, craniofacial proportions, and mechanism of injury. Even if a similar fracture pattern were observed, the treatment for patients of different ages would vary. The differences in craniofacial anatomy, patterns of injury, and capacity for remodeling and future growth must all be considered when determining a specific treatment option. It is paramount to remember that the pediatric patient is not just a small adult. Even with similarly aged patients and fracture patterns, the treatment plan must take into account patient and parent compliance and stage of dentition in that particular child.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  • Anderson FM, Geiger L. Craniosynostosis: a survey of 204 cases. J Neurosurg. 1965;22:229–40.

    Article  PubMed  CAS  Google Scholar 

  • Bite U, Jackson IT, Forbes GS, Gehring DG. Orbital volume measurements in enophthalmos using three-dimensional Ct imaging. Plast Reconstr Surg. 1985;75:502–8.

    Article  PubMed  CAS  Google Scholar 

  • Burstein F, Cohen S, Hudgins R, Boydston W. Frontal basilar trauma: classification and treatment. Plast Reconstr Surg. 1997;99:1314–21; discussion 1322–3.

    Article  PubMed  CAS  Google Scholar 

  • Chao MT, Losee JE. Complications in pediatric facial fractures. Craniomaxillofac Trauma Reconstr. 2009;2:103.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chao MT, Jiang S, Smith D, DeCesare GE, Cooper GM, Pollack IF, Girotto J, Losee JE. Demineralized bone matrix and resorbable mesh bilaminate cranioplasty: a novel method for reconstruction of large-scale defects in the pediatric calvaria. Plast Reconstr Surg. 2009;123:976–82.

    Article  PubMed  CAS  Google Scholar 

  • Chen KT, Chen CT, Mardini S, Tsay PK, Chen YR. Frontal sinus fractures: a treatment algorithm and assessment of outcomes based on 78 clinical cases. Plast Reconstr Surg. 2006;118:457–68.

    Article  PubMed  CAS  Google Scholar 

  • Cho YR, Gosain AK. Biomaterials in craniofacial reconstruction. Clin Plast Surg. 2004;31:377–85, v.

    Article  PubMed  Google Scholar 

  • Cole P, Boyd V, Banerji S, Hollier Jr LH. Comprehensive management of orbital fractures. Plast Reconstr Surg. 2007;120:57S–63.

    Article  PubMed  CAS  Google Scholar 

  • Converse JM, Smith B, Obear MF, Wood-Smith D. Orbital blowout fractures: a ten-year survey. Plast Reconstr Surg. 1967;39:20–36.

    Article  PubMed  CAS  Google Scholar 

  • Cope MR, Moos KF, Speculand B. Does diplopia persist after blow-out fractures of the orbital floor in children? Br J Oral Maxillofac Surg. 1999;37:46–51.

    Article  PubMed  CAS  Google Scholar 

  • David L, Argenta L, Fisher D. Hydroxyapatite cement in pediatric craniofacial reconstruction. J Craniofac Surg. 2005;16:129–33.

    Article  PubMed  Google Scholar 

  • Demianczuk AN, Verchere C, Phillips JH. The effect on facial growth of pediatric mandibular fractures. J Craniofac Surg. 1999;10:323.

    Article  PubMed  CAS  Google Scholar 

  • Dufresne CR, Manson P. Pediatric facial injuries. In: Mathes SJ, editor. The head and neck, part 2, vol. 3. Philadelphia: Elsevier; 2006.

    Google Scholar 

  • Eggensperger Wymann NM, Holzle A, Zachariou Z, Iizuka T. Pediatric craniofacial trauma. J Oral Maxillofac Surg. 2008;66:58–64.

    Article  PubMed  Google Scholar 

  • Farkas LG, Posnick JC, Hreczko TM. Growth patterns of the face: a morphometric study. Cleft Palate Craniofac J. 1992;29:308–15.

    Article  PubMed  CAS  Google Scholar 

  • Ferreira PC, Amarante JM, Silva PN, Rodrigues JM, Choupina MP, Silva AC, Barbosa RF, Cardoso MA, Reis JC. Retrospective study of 1251 maxillofacial fractures in children and adolescents. Plast Reconstr Surg. 2005;115:1500–8.

    Article  PubMed  CAS  Google Scholar 

  • Gassner R, Tuli T, Hachl O, Moreira R, Ulmer H. Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years. J Oral Maxillofac Surg. 2004;62:399–407.

    Article  PubMed  Google Scholar 

  • Grunwaldt L, Smith DM, Zuckerbraun NS, Naran S, Rottgers SA, Bykowski M, Kinsella C, Cray J, Vecchione L, Saladino RA, Losee JE. Pediatric facial fractures: demographics, injury patterns, and associated injuries in 772 consecutive patients. Plast Reconstr Surg. 2011;128:1263–71.

    Article  PubMed  CAS  Google Scholar 

  • Hatef DA, Cole PD, Hollier Jr LH. Contemporary management of pediatric facial trauma. Curr Opin Otolaryngol Head Neck Surg. 2009;17:308–14.

    Article  PubMed  Google Scholar 

  • Havlik RJ, Sutton LN, Bartlett SP. Growing skull fractures and their craniofacial equivalents. J Craniofac Surg. 1995;6:103–10; discussion 111–2.

    Article  PubMed  CAS  Google Scholar 

  • Holland AJ, Broome C, Steinberg A, Cass DT. Facial fractures in children. Pediatr Emerg Care. 2001;17:157–60.

    Article  PubMed  CAS  Google Scholar 

  • Imahara SD, Hopper RA, Wang J, Rivara FP, Klein MB. Patterns and outcomes of pediatric facial fractures in the United States: a survey of the national trauma data bank. J Am Coll Surg. 2008;207:710–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jordan DR, Allen LH, White J, Harvey J, Pashby R, Esmaeli B. Intervention within days for some orbital floor fractures: the white-eyed blowout. Ophthal Plast Reconstr Surg. 1998;14:379–90.

    Article  PubMed  CAS  Google Scholar 

  • Kaban LB, Mulliken JB, Murray JE. Facial fractures in children: an analysis of 122 fractures in 109 patients. Plast Reconstr Surg. 1977;59:15–20.

    Article  PubMed  CAS  Google Scholar 

  • Lehman Jr JA, Saddawi ND. Fractures of the mandible in children. J Trauma. 1976;16:773–7.

    Article  PubMed  Google Scholar 

  • Losee JE, Jiang S. Pediatric facial trauma. In: Chung K, Disa J, Gosain AK, et al., editors. Plastic surgery. New York: Saunders Elsevier; 2009. p. 645–55.

    Google Scholar 

  • Losee JE, Smith DM. Pediatric facial fractures. In: Neligan P, editor. Plastic surgery, vol. 3. 3rd ed. London: Elsevier; 2012. p. 671–85.

    Google Scholar 

  • Losee JE, Afifi A, Jiang S, Smith D, Chao MT, Vecchione L, Hertle R, Davis J, Naran S, Hughes J, Paviglianiti J, Deleyiannis FW. Pediatric orbital fractures: classification, management, and early follow-up. Plast Reconstr Surg. 2008a;122:886–97.

    Article  PubMed  CAS  Google Scholar 

  • Losee JE, Jiang S, Deleyiannis FW. Craniofacial fractures. In: Bentz M, Bauer B, Zuker R, editors. Principles and practice of pediatric plastic surgery. St. Louis: Quality Medical Publishing; 2008b. p. 1047–72.

    Google Scholar 

  • Manson PN, Iliff N. Management of blow-out fractures of the orbital floor. II. Early repair for selected injuries. Surv Ophthalmol. 1991;35:280–92.

    Article  PubMed  CAS  Google Scholar 

  • Manson PN, Grivas A, Rosenbaum A, Vannier M, Zinreich J, Iliff N. Studies on enophthalmos: II. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg. 1986;77:203–14.

    Article  PubMed  CAS  Google Scholar 

  • Markowitz BL, Manson PN, Sargent L, Vander Kolk CA, Yaremchuk M, Glassman D, Crawley WA. Management of the medial canthal tendon in nasoethmoid orbital fractures: the importance of the central fragment in classification and treatment. Plast Reconstr Surg. 1991;87:843–53.

    Article  PubMed  CAS  Google Scholar 

  • Mathes SJ, editor. Plastic surgery, vol. 3. 2nd ed. Philadelphia: Elsevier; 2006.

    Google Scholar 

  • Mathog RH, editor. Maxillofacial trauma. Baltimore: Williams & Wilkins; 1983.

    Google Scholar 

  • McCoy FJ, Chandler RA, Crow ML. Facial fractures in children. Plast Reconstr Surg. 1966;37:209–15.

    Article  PubMed  CAS  Google Scholar 

  • Mericli AF, DeCesare GE, Zuckerbraun NS, Kurland KS, Grunwaldt L, Vecchione L, Losee JE. Pediatric craniofacial fractures due to violence: comparing violent and nonviolent mechanisms of injury. J Craniofac Surg. 2011;22:1342–7.

    Article  PubMed  Google Scholar 

  • Messinger A, Radkowski MA, Greenwald MJ, Pensler JM. Orbital roof fractures in the pediatric population. Plast Reconstr Surg. 1989;84:213–6; discussion 217–8.

    Article  PubMed  CAS  Google Scholar 

  • Moss ML, Salentijn L. The primary role of functional matrices in facial growth. Am J Orthod. 1969;55:566–77.

    Article  PubMed  CAS  Google Scholar 

  • Naran S, Afrooz PN, Bykowski MR, Smith DM, Rottgers SA, Losee JE. Arch bar use in primary and mixed dentition: feasibility, safety and outcomes. Plast Reconstr Surg. 130:100. Abstract 34p.

    Google Scholar 

  • Pappachan B, Alexander M. Correlating facial fractures and cranial injuries. J Oral Maxillofac Surg. 2006;64:1023–9.

    Article  PubMed  Google Scholar 

  • Parsons GS, Mathog RH. Orbital wall and volume relationships. Arch Otolaryngol Head Neck Surg. 1988;114:743–7.

    Article  PubMed  CAS  Google Scholar 

  • Perheentupa U, Kinnunen I, Grenman R, Aitasalo K, Makitie AA. Management and outcome of pediatric skull base fractures. Int J Pediatr Otorhinolaryngol. 2010;74:1245–50.

    Article  PubMed  Google Scholar 

  • Roaten JB, Partrick DA, Nydam TL, Bensard DD, Hendrickson RJ, Sirotnak AP, Karrer FM. Nonaccidental trauma is a major cause of morbidity and mortality among patients at a regional level 1 pediatric trauma center. J Pediatr Surg. 2006;41:2013–5.

    Article  PubMed  Google Scholar 

  • Rodriguez ED, Stanwix MG, Nam AJ, St Hilaire H, Simmons OP, Christy MR, Grant MP, Manson PN. Twenty-six-year experience treating frontal sinus fractures: a novel algorithm based on anatomical fracture pattern and failure of conventional techniques. Plast Reconstr Surg. 2008;122:1850–66.

    Article  PubMed  CAS  Google Scholar 

  • Rottgers SA, DeCesare G, Chao M, Smith DM, Cray JJ, Naran S, Vecchione L, Grunwaldt L, Losee JE. Outcomes in pediatric facial fractures: early follow-up in 177 children and classification scheme. J Craniofac Surg. 2011;22(4):1260–5.

    Google Scholar 

  • Sherick DG, Buchman SR, Patel PP. Pediatric facial fractures: a demographic analysis outside an urban environment. Ann Plast Surg. 1997;38:578–84; discussion 584–5.

    Article  PubMed  CAS  Google Scholar 

  • Singh DJ, Bartlett SP. Pediatric craniofacial fractures: long-term consequences. Clin Plast Surg. 2004;31:499–518, vii.

    Article  PubMed  Google Scholar 

  • Smartt Jr JM, Low DW, Bartlett SP. The pediatric mandible: II. Management of traumatic injury or fracture. Plast Reconstr Surg. 2005;116:28e–41.

    Article  PubMed  Google Scholar 

  • Smith DM. Mandible fractures in 96 children: demographics, treatment, early outcomes and a prospective analysis of growth and development. Oxford: Society of Craniofacial Surgery XIII Biennial International Congress, 2009; 2009.

    Google Scholar 

  • Smith DM, Bykowski MR, Cray JJ, Naran SS, Rottgers A, Shakir S, Vecchione L, Schuster L, Losee JE. 215 mandible fractures in 120 children: demographics, treatment, outcomes, and early growth data. Plast Reconstr Surg. 2013;131(6):1348–58.

    Google Scholar 

  • Thaller SR, Huang V. Midfacial fractures in the pediatric population. Ann Plast Surg. 1992;29:348–52.

    Article  PubMed  CAS  Google Scholar 

  • Thoren H, Iso-Kungas P, Iizuka T, Lindqvist C, Tornwall J. Changing trends in causes and patterns of facial fractures in children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:318–24.

    Article  PubMed  Google Scholar 

  • Vyas RM, Dickinson BP, Wasson KL, Roostaeian J, Bradley JP. Pediatric facial fractures: current national incidence, distribution, and health care resource use. J Craniofac Surg. 2008;19:339–49; discussion 350.

    Article  PubMed  Google Scholar 

  • Ziccardi VB, Ochs MW, Braun TW, Malave DA. Management of condylar fractures in children: review of the literature and case presentations. Compend Contin Educ Dent. 1995;16:874, 876, 878–80 passim; quiz 888.

    PubMed  CAS  Google Scholar 

  • Zimmermann CE, Troulis MJ, Kaban LB. Pediatric facial fractures: recent advances in prevention. Diagnosis and management. Int J Oral Maxillofac Surg. 2006;35:2–13.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Laura A. Monson MD

  2. Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Darren M. Smith MD & Joseph E. Losee MD, FACS, FAAP

  3. Division of Pediatric Plastic Surgery, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Joseph E. Losee MD, FACS, FAAP

Authors
  1. Laura A. Monson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Darren M. Smith MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph E. Losee MD, FACS, FAAP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph E. Losee MD, FACS, FAAP .

Editor information

Editors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Mount Sinai Medical Center, New York, New York, USA

    Peter J. Taub

  2. Division of Plastic, Reconstructive and Cosmetic Surgery; Pediatric Plastic and Craniofacial Surgery, University of Illinois, Chicago, Illinois, USA

    Pravin K. Patel

  3. Division of Plastic and Reconstructive Surgery; Craniofacial Anomalies Program, University of Michigan Medical School, Ann Arbor, Michigan, USA

    Steven R. Buchman

  4. Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois, Chicago, Illinois, USA

    Mimis N. Cohen

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Monson, L.A., Smith, D.M., Losee, J.E. (2015). Pediatric Facial Fractures. In: Taub, P., Patel, P., Buchman, S., Cohen, M. (eds) Ferraro's Fundamentals of Maxillofacial Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8341-0_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8341-0_23

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8340-3

  • Online ISBN: 978-1-4614-8341-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation