@article{ref1,
title="Maxillofacial injuries in pediatric patients",
journal="Journal of cranialfacial surgery",
year="2021",
author="Yang, Rong-Tao and Li, Zu-Bing and Li, Zhi and Lv, Kun and Zhou, Hai-Hua",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: This study aimed to evaluate and analyse the demographic characteristics and changes in maxillofacial injuries during their development in pediatric  patients. <br><br>METHODS: A retrospective cohort and case-control study was conducted. The  sample was composed of all children (less than 10.5 years) who presented with  maxillofacial injuries within a 6.5-year period (from December 2012 to April 2019). Data about age, gender, hospitalization date, mechanism of trauma, location and  pattern of injuries, associated general injuries or systemic diseases, admission  methods (emergency admission or not), type of anesthesia, treatment methods and  hospital costs (¥) were recorded and analyzed. Data analysis included Chi-square  test, Fisher exact test, and t test. Univariate and multivariate analyses were also  performed. Logistic regression analysis was used to control for confounding  variables. Differences at P < 0.05 were considered significant. <br><br>RESULTS: A total of  643 pediatric patients were included in this study, with a boy-to-girl ratio of  1.77:1 (411 boys and 232 girls). The age range was 0.18 to 10.5 years (average of  3.23 ± 1.98 years). The largest age group was patients aged 1 to 2 years (200  patients, 31.1%), followed by 2 to 3 years (139 patients, 21.6%). In the majority of  patients, fall at ground level was the most common mechanism of injury (391  patients, 60.8%). In addition, 613 patients (95.3%) sustained at least maxillofacial  soft-tissue injuries, while 460 (71.5%) sustained only maxillofacial soft-tissue  injuries and 183 (28.5%) sustained maxillofacial fractures. Lip was the most  vulnerable soft tissue to be injured (283 patients, 44.0%). Patients who sustained  maxillofacial soft-tissue injuries were less prone to maxillofacial fractures than  those who did not. Maxillofacial fractures were highly presented in patients with  dental injuries (OR = 6.783; 95% confidence interval, 3.147-14.620; P < 0.001). Older children (> 5 years old) were at higher risk of maxillofacial fractures than  younger children (≤ 5 years old, P = 0.006). The risk of maxillofacial fractures  (except symphysis fractures) increased with age, especially in patients aged between  5 and 10 years. Maxillofacial soft-tissue injuries were highly distributed amongst  patients aged 1 to 5 years. The number of patients who sustained only maxillofacial  soft-tissue injuries gradually decreased from 2013 to 2018. Patients in emergency  admission (OR = 13.375; 95% confidence interval, 1.286-139.121; P = 0.030) and  treated under general anesthesia (OR = 27015.375; 95% confidence interval,  1033.046-706484.218; P < 0.001) were more prone to be treated by surgery procedure. Patients with facial fractures were less frequent to be treated by surgery procedure  (OR = 0.006; 95% confidence interval, 0.000-0.575; P = 0.028); however, the  mandibular symphysis (OR = 18.141; 95% confidence interval, 2.860-115.069;  P = 0.002) or body fractures (OR = 71.583; 95% confidence interval, 2.358-2172.879;  P = 0.014) were highly treated by surgery procedure. <br><br>CONCLUSIONS: Maxillofacial  fractures in pediatric patients were significantly related to age, etiology,  maxillofacial soft-tissue injury, dental injury and other general injuries. Older  pediatric patients were at higher risk of maxillofacial fractures (except symphysis  fractures) and lower risk of maxillofacial soft-tissue injuries than younger  pediatric patients. Patients in emergency admission, fractures of the symphysis or  body, and treated under general anesthesia were the main reasons for surgical  management.<p /> <p>Language: en</p>",
language="en",
issn="1049-2275",
doi="10.1097/SCS.0000000000007402",
url="http://dx.doi.org/10.1097/SCS.0000000000007402"
}