title: Pediatric craniofacial fractures due to violence: comparing violent and nonviolent mechanisms of injury.
abstract: BACKGROUND
  This study examines the epidemiologic data of pediatric craniofacial fractures secondary to violence, comparing these data to craniofacial fractures sustained from all other causes.
  
  
  METHODS
  A retrospective review was completed on all patients who presented to the emergency department of a major urban children's hospital from 2000 to 2005 with a craniofacial fracture. Data were compared between patients with fractures due to violent and nonviolent mechanisms. Socioeconomic analysis was performed using Geographic Information System mapping and 2000 US Census data by postal code.
  
  
  RESULTS
  One thousand five hundred twenty-eight patients were diagnosed with skull and/or facial fractures. Isolated skull fractures were excluded, leaving 793 patients in the study. Ninety-eight children were injured due to violence, and 695 were injured from a nonviolent cause. Patients with violence-related fractures were more likely to be older, male, and nonwhite and live in a socioeconomically depressed area. A greater number of patients with violence-related injuries sustained nasal and mandible angle fractures, whereas more patients with non-violence-related injuries sustained skull and orbital fractures. Those with violence-related craniofacial fractures had a lower percentage of associated multiorgan system injuries and a lower rate of hospital admissions and intensive care unit admissions. The rate of open reduction and internal fixation for craniofacial fractures was similar in both groups.
  
  
  CONCLUSIONS
  Patients with violence-related fractures had fewer associated serious injuries and lower morbidity and lived in a more socioeconomically depressed area. The information gained from this descriptive study improves our ability to characterize this population of pediatric patients and to identify the associated constellation of injuries in such fractures.
authors.affiliation: Department of Plastic Surgery, University of Virginia Health System, USA.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Mericli
authors.forename: Gary E
authors.initials: GE
authors.lastname: DeCesare
authors.forename: Noel S
authors.initials: NS
authors.lastname: Zuckerbraun
authors.forename: Kristen S
authors.initials: KS
authors.lastname: Kurland
authors.forename: Lorelei
authors.initials: L
authors.lastname: Grunwaldt
authors.forename: Lisa
authors.initials: L
authors.lastname: Vecchione
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Losee
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000367:Age Factors; D001265:Athletic Injuries / Q000453:epidemiology; D002648:Child; D003422:Critical Care / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008337:Mandibular Fractures / Q000453:epidemiology; D009295:Nasal Bone / Q000293:injuries; D009917:Orbital Fractures / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D012887:Skull Fractures / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014754:Violence / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000706:statistics & numerical data