Cause of Fractures Varies by Age and Socioeconomic Status
(HealthNewsDigest.com) – ARLINGTON HEIGHTS, Ill., Nov. 21, 2011 — Facial fractures in children occur in different patterns in different age groups, but most often occur with other types of severe injuries, reports a study in the December issue of Plastic and Reconstructive Surgery(R), the official medical journal of the American Society of Plastic Surgeons (ASPS).
The study lends new insights into trends in the demographics, diagnosis
and treatment of pediatric facial fractures–including higher rates of
fractures caused by violence among adolescents, low-income and minority
youth. The study was led by ASPS Member Surgeon Joseph E. Losee, MD, of
Children’s Hospital of Pittsburgh.
In-Depth Analysis of 722 Pediatric Facial Fractures
The researchers analyzed facial fractures in infants, children and
adolescents over a five-year period. They focused on differences in
patient characteristics, fracture patterns and treatment in three age
groups: 5 years and under, 6 to 11 years, and 12 to 18 years. The study
excluded children who had skull fracture only, without fracture of the
facial bones.
The average age was 10.7 years, and 69 percent of the patients were
boys. Orbital fractures–fractures in and around the eye socket–were
the most common type in all age groups. Rates of jaw, nasal and other
types of fractures increased with age. Infants and young children were
more likely to need treatment in the intensive care unit, while older
children were more likely to need surgery.
Motor vehicle crashes were the most common cause, responsible for 21
percent of facial fractures. However, causes varied by age group:
— Infants and children up to age 5 accounted for 20 percent of facial
fractures. They were most likely to be injured in falls– none were
injured in violence.
— Children ages 6 to 11 accounted for 33 percent of facial fractures.
Motor vehicle crashes were the most common cause, followed by play and
bicycle riding.
— Adolescents ages 12 to 18 were the largest group with facial fractures
at 47 percent. Violence was the most common cause of facial fractures in
teens, followed by sports-related injuries.
Across age groups, 56 percent of children had other types of traumatic
injuries, including a 22 percent rate of concussions. Overall, 63
percent of children were hospitalized and 1.4 percent died.
About 12 percent of facial fractures resulted from violence. Violent
injuries were more likely for minority children and those living in
low-income neighborhoods.
Facial fractures are less common in children than adults; less than 15
percent of facial fractures occur in children. Because the skull and
facial bones of children are “anatomically distinct” from those of
adults, they are subject to unique injury patterns. Because of these
distinct patterns, along with concern for future growth, surgeons must
approach facial fractures in children as “fundamentally different” from
those in adults.
The study is one of the first to look at the full range of facial
fractures in children, from infancy through adolescence. Anatomy
explains the higher rate of middle-third facial fractures in older
children. Because of the relatively large size of the cranial bones in
infants and young children, they are more likely to sustain isolated
skull fractures rather than facial fractures.
The results call attention to the high rate of facial fractures caused
by violence in boys, especially minorities and those in low-income
areas. Dr. Losee and colleagues hope their findings will help plastic
and reconstructive surgeons develop new and more effective approaches
to diagnosis, treatment and prevention of these unique injuries.
Plastic and Reconstructive Surgery(R) is published by Lippincott
Williams & Wilkins, part of Wolters Kluwer Health.
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery(R)
(http://journals.lww.com/plasreconsurg/) has been the one consistently
excellent reference for every specialist who uses plastic surgery
techniques or works in conjunction with a plastic surgeon. The official
journal of the American Society of Plastic Surgeons, Plastic and
Reconstructive Surgery(R) brings subscribers up-to-the-minute reports
on the latest techniques and follow-up for all areas of plastic and
reconstructive surgery, including breast reconstruction, experimental
studies, maxillofacial reconstruction, hand and microsurgery, burn
repair, and cosmetic surgery, as well as news on medico-legal issues.
About ASPS
The American Society of Plastic Surgeons (ASPS) is the world’s largest
organization of board-certified plastic surgeons. Representing more
than 7,000 Member Surgeons, the Society is recognized as a leading
authority and information source on cosmetic and reconstructive plastic
surgery. ASPS comprises more than 94 percent of all board-certified
plastic surgeons in the United States. Founded in 1931, the Society
represents physicians certified by The American Board of Plastic
Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS
advances quality care to plastic surgery patients by encouraging high
standards of training, ethics, physician practice and research in
plastic surgery. For more information, please visit
www.plasticsurgery.org.
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