Management of pediatric facial injuries in a rural referral center-Case series

Abstract

: Pediatric injuries involving the facial bone are associated with severe injury and trauma. Trauma is one of the leading causes of morbidity and mortality in children. Although less, maxillofacial fractures contribute to an important part of morbidity in children.: Nineteen children with facial trauma (range 6-16 years of age) were treated in a rural medical college in Tamil Nadu, India. Mostly they were soft tissue injuries out of whom nine patients were with bony injuries. The mean study time is 10.4 months; however, the maximum follow-up is 3 years. Most of the injuries were treated conservatively, MMF and Splints, however ORIF with plate and screws were done in four cases. Soft tissue injuries are more common than bony injuries in children. Parents were very anxious and patients were not cooperative and convincing them for treatment of these fractures was difficult. This is because of illiteracy and poor socio-economic status in rural areas. ORIF was done with minimal periosteal stripping. Children tolerate MMF poorly and to our surprise, these patients tolerate ORIF with plates and screws better. Orthodontic hard stainless-steel wires were also used in a few cases to minimize surgical procedures. We were not able to use absorbable plates because of cost factor. Facial injuries with fractures of facial bones in children are uncommon but occur more frequently in major trauma like motor vehicle accidents and sports-related injuries. The greater osteogenic potential and faster healing rate in children help us to treat with conservative therapeutic procedures and with minimal displacement of fractures.