Differences in Facial Fracture Patterns in Pediatric Nonaccidental Trauma.
J Craniofac Surg
; 31(4): 956-959, 2020 Jun.
Article
em En
| MEDLINE
| ID: mdl-32176005
ABSTRACT
BACKGROUND:
The purpose of this study was to characterize differences in facial fracture injury patterns among pediatric patients at highest risk of abusive head trauma/nonaccidental trauma (ageâ≤â5 years).METHODS:
Using the National Trauma Databank from 2007 to 2015, patients (ageâ≤â5 years) suffering facial fractures were included. Demographics and injury characteristics were compared between those sustaining accidental versus nonaccidental trauma (NAT).RESULTS:
Over 9 years 9741 patients were included with 193 patients (2.0%) suffering NAT. Nonaccidental trauma patients were younger (median [interquartile range]; 0 [0, 2] versus 3 [1, 4], Pâ<â0.001), and more frequently were insured by Medicaid (76.7% versus 41.9%, Pâ<â0.001). NAT patients were more likely to sustain mandible fractures (38.9% versus 21.1%, Pâ<â0.001), but less likely to sustain maxilla (9.8% versus 18.3%, Pâ=â0.003), or orbital fractures (31.1% versus 53.4%, Pâ<â0.001). Nonaccidental trauma patients had fewer instances of multiple facial fracture sites (8.9% versus 22.6%, Pâ<â0.001). Among those sustaining mandible fractures, NAT patients were more likely to sustain condylar fractures (75.8% versus 48.4%, Pâ<â0.001), but less likely to sustain subcondylar fractures (0% versus 13.2%, Pâ=â0.002), or angle fractures (1.6 versus 8.7%, Pâ=â0.048).CONCLUSIONS:
Differences exist in facial fracture patterns in accidental versus nonaccidental trauma within the pediatric population at highest risk for abusive head trauma. Specifically, NAT is associated with fractures of the mandibular condyle and involve fewer facial fracture sites. In the appropriate context, presence of these fractures/patterns should increase suspicion for NAT.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fraturas Cranianas
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Humans
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Infant
/
Newborn
Idioma:
En
Revista:
J Craniofac Surg
Assunto da revista:
ODONTOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article