title: Pediatric Maxillofacial Trauma: A Review of 156 Patients.
abstract: OBJECTIVE
  To review the epidemiology and management of facial fractures in a pediatric population.
  
  
  METHODS
  This study was a retrospective review of patients younger than 18 years who presented to a pediatric emergency department during a 5-year period in an urban, academic, level 1 designated trauma center.
  
  
  RESULTS
  Of the 156 patients identified, most were boys (87%) and the mean age was 13.5 years (standard deviation, 4.9 yr; interquartile range, 12 to 17 yr). The most common mechanism of injury was assault (48.1%). Mandibular fractures (40.7%) were most common. Multiple fractures occurred in 26.9% of patients. Concomitant injuries occurred in 73.7% of patients, most commonly concussions (39.1%). Intracranial hemorrhages were associated with panfacial (P = .005), frontal (P = .001), and orbital (P = .04) fractures. Most patients (91.7%) were admitted, and nonoperative repair was undertaken in 57.1%. There was an independent association of surgical intervention with age older than 14 years and with mandibular fractures (P < .01).
  
  
  CONCLUSIONS
  Assault was the most common mechanism of injury and mandibular fracture was the most commonly encountered. Concomitant nonfacial injuries occurred in most patients. Patients sustaining panfacial, frontal, and orbital fractures should provoke an evaluation for other intracranial injuries. Children older than 14 years and those with mandibular fractures should prompt mobilization of resources for operative repair.
authors.affiliation: Former Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Otolaryngology, Mount Sinai Beth Israel, New York, NY. Electronic address: halshetawi@gmail.com.
authors.forename: Al Haitham
authors.initials: AH
authors.lastname: Al Shetawi
authors.affiliation: Assistant Professor of Pediatrics, Pediatric Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: C Anthoney
authors.initials: CA
authors.lastname: Lim
authors.affiliation: Private Practice, Midwest Oral and Maxillofacial Surgery, Fort Wayne, IN.
authors.forename: Yash K
authors.initials: YK
authors.lastname: Singh
authors.affiliation: Associate Clinical Professor, Department of Oral and Maxillofacial Surgery, Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, FL.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Portnof
authors.affiliation: Assistant Professor of Pediatrics, Pediatric Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D009519:New York City / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors