title: Age and sex-related differences in 431 pediatric facial fractures at a level 1 trauma center.
abstract: BACKGROUND
  Age and sex-related changes in the pattern of fractures and concomitant injuries observed in this patient population is helpful in understanding craniofacial development and the treatment of these unique injuries. The goal of this study was to examine all facial fractures occurring in a child and adolescent population (age 18 or less) at a trauma center to determine any age or sex-related variability amongst fracture patterns and concomitant injuries.
  
  
  METHODS
  All facial fractures occurring at a trauma center were collected over a 12-year period based on International Classification of Disease, rev. 9 codes. This was delimited to include only those patients 18 years of age or younger. Age, sex, mechanism, and fracture types were collected and analyzed.
  
  
  RESULTS
  During this time period, there were 3147 patients with facial fractures treated at our institution, 353 of which were in children and adolescent patients. Upon further review 68 patients were excluded due to insufficient data for analysis, leaving 285 patients for review, with a total of 431 fractures. The most common etiology of injury was assault for males and motor vehicle accidents (MVA) for females. The most common fracture was of the mandible in males and of the orbit in females. The most common etiology in younger age groups includes falls and pedestrian struck. Older age groups exhibit a higher incidence of assault-related injuries. Younger age groups showed a propensity for orbital fractures as opposed to older age groups where mandibular fractures predominated. Intracranial hemorrhage was the most common concomitant injury across most age groups.
  
  
  CONCLUSIONS
  The differences noted in etiology of injury, fracture patterns, and concomitant injuries between sexes and different age groups likely reflects the differing activities that each group engages in predominantly. In addition the growing facial skeleton offers varying degrees of protection to the cranial contents as force-absorbing mechanisms develop.
authors.affiliation: New Jersey Medical School, Rutgers Biomedical Health Sciences, Division of Plastic Surgery, Department of Surgery, Newark, NJ 07103, United States. Electronic address: ianhoppe@gmail.com.
authors.forename: Ian C
authors.initials: IC
authors.lastname: Hoppe
authors.affiliation: New Jersey Medical School, Rutgers Biomedical Health Sciences, Division of Plastic Surgery, Department of Surgery, Newark, NJ 07103, United States.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Kordahi
authors.affiliation: New Jersey Medical School, Rutgers Biomedical Health Sciences, Division of Plastic Surgery, Department of Surgery, Newark, NJ 07103, United States.
authors.forename: Angie M
authors.initials: AM
authors.lastname: Paik
authors.affiliation: New Jersey Medical School, Rutgers Biomedical Health Sciences, Division of Plastic Surgery, Department of Surgery, Newark, NJ 07103, United States.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Lee
authors.affiliation: New Jersey Medical School, Rutgers Biomedical Health Sciences, Division of Plastic Surgery, Department of Surgery, Newark, NJ 07103, United States.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Granick
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020198:Intracranial Hemorrhage, Traumatic / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008337:Mandibular Fractures / Q000453:epidemiology; D009104:Multiple Trauma / Q000453:epidemiology; D009515:New Jersey / Q000453:epidemiology; D009917:Orbital Fractures / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D012887:Skull Fractures / Q000453:epidemiology*; D014754:Violence / Q000706:statistics & numerical data
keywords: Adolescent; Child; Facial bones/injuries; Humans; Infant; Multiple trauma/epidemiology/etiology/mortality