Wainwright D'Arcy J, Moffitt Joseph K, Bartz-Kurycki Marisa, Wainwright David J, Anderson Kathryn, Demian Nagi, Teichgraeber John F, Greives Matthew R
Division of Pediatric Plastic Surgery, Department of Pediatric Surgery, McGovern School of Medicine at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital.
Division of Plastic Surgery, Department of Surgery, McGovern School of Medicine at the University of Texas Health Science Center at Houston.
J Craniofac Surg. 2019 Oct;30(7):1970-1973. doi: 10.1097/SCS.0000000000005613.
Pediatric facial fractures due to intentionally violent mechanisms represent a unique subset of facial fractures. The objective of our research is to identify how violence affects patterns of facial fractures and their management in pediatric patients.
An IRB approved, retrospective study of our institution's pediatric patients ≤18 years of age who presented with ≥1 facial fracture due to violence from January 2006 to December 2015 was performed. Violence was defined as trauma intended to hurt another or self. Demographics, fractures, mechanism, concomitant injuries, and management were analyzed.
The 1274 patients were diagnosed with facial fractures, with 235 of these due to violence (18%). These patients of violence (POV) had 332 fractures, with an average fracture per patient of 1.4 ± .0.8. The majority (86%) were male, Non-Hispanic African American (35%), and the average age was 15.9 ± 2.8 years. The most common fracture was the mandible (50% of patients) and most common mechanism was assault (76%). The POV were older, male, and of minority race/ethnic groups when compared to patients of non-violence (PONV) (P <0.01). The POV presented with fewer concomitant injuries, were less likely to be admitted to the intensive care unit, and more often surgically managed when compared to the PONV (P <0.01).
This study represents the largest US, single institution, Level 1 trauma center study of pediatric facial fractures. Pediatric patients with facial fractures due to a violent mechanism represent a distinct category of trauma patients with a unique profile of injuries.
因故意暴力机制导致的小儿面部骨折是面部骨折中的一个独特子集。我们研究的目的是确定暴力如何影响小儿患者面部骨折的模式及其治疗。
对2006年1月至2015年12月期间在我们机构就诊的18岁及以下因暴力导致≥1处面部骨折的小儿患者进行了一项经机构审查委员会批准的回顾性研究。暴力被定义为旨在伤害他人或自身的创伤。对人口统计学、骨折情况、受伤机制、伴随损伤和治疗情况进行了分析。
1274例患者被诊断为面部骨折，其中235例是由暴力所致（18%）。这些暴力所致患者（POV）共有332处骨折，平均每位患者骨折1.4±0.8处。大多数（86%）为男性，非西班牙裔非裔美国人（35%），平均年龄为15.9±2.8岁。最常见的骨折是下颌骨骨折（占患者的50%），最常见的受伤机制是袭击（76%）。与非暴力患者（PONV）相比，POV患者年龄更大、为男性且属于少数种族/族裔群体（P<0.01）。与PONV相比，POV患者伴随损伤较少，入住重症监护病房的可能性较小，且手术治疗更为常见（P<0.01）。
本研究是美国最大的单机构一级创伤中心对小儿面部骨折的研究。因暴力机制导致面部骨折的小儿患者代表了一类独特的创伤患者，具有独特的损伤特征。
