Paediatric Maxillofacial Fractures: A Five-Year Retrospective Review of Patterns, Management and Outcomes

Abstract

Introduction: Facial fractures in children are far less common than in adults but pose greater management challenges because of skeletal growth and developing dentition. This study reviewed the distribution of paediatric facial fractures, treatment methods, and short-term outcomes at a tertiary oral and maxillofacial unit.

Methods: Records of all patients aged ≤18 years with radiologically confirmed facial fractures treated between January 2019 and December 2023 were retrospectively examined. Data collected included demographics, cause of injury, fracture site, management, and outcome. Fractures were classified as mandibular subsites, midfacial/zygomatic, or other mandibular regions. Outcomes were judged by healing, occlusion, facial symmetry, and complications.

Results: Sixty children (mean age 12.4 years, range 2–18) were included. Males were the majority (68.3%). Falls were the most frequent cause (61.7%), followed by road traffic accidents (28.3%). Mandibular fractures predominated (68.3%). Closed reduction was undertaken in 40% of cases, while 60% required open reduction and internal fixation (ORIF). The choice of treatment was strongly linked to the fracture site (χ²=9.47, p=0.003). At a mean follow-up of 10.3 months, 95% achieved satisfactory outcomes, with only three minor complications (two malocclusions, one local infection).

Conclusions: The mandible is the most commonly fractured facial bone in children. While many injuries respond to conservative care, displaced fractures often need ORIF. Careful case selection allows excellent outcomes with minimal complications. Long-term surveillance is vital to detect potential growth-related sequelae.