Hinson Madison, Wright Avery, Davidson Amelia, Kogan Samuel, Runyan Christopher
Department of Plastic Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Craniomaxillofac Trauma Reconstr. 2024 Dec;17(4):NP192-NP203. doi: 10.1177/19433875241272430. Epub 2024 Aug 5.
Retrospective chart review.
The management of pediatric facial fractures presents distinctive considerations compared to adults. This study aims to provide a unique perspective on the correlations between the mechanism of injury, types of facial fractures, and fracture interventions and management utilized in 2 North Carolina Level 1 Trauma Centers to determine the optimal management options for this patient population.
An IRB-approved retrospective chart review was performed of pediatric facial trauma patients ages <18 years old between January 2020 and December 2022 at Atrium Health Wake Forest Baptist Medical Center and Atrium Health Charlotte Medical Center. Data on patient demographics, mechanism of injury, facial fractures, interventions, and outcomes were collected.
Of 2,977 pediatric facial trauma patients, 582 patients sustained at least 1 facial fracture at the time of injury. Adolescents were significantly less likely to be transferred from outside institutions and to be admitted for further care ( = 0.002). Adolescents experienced higher levels of residual symptoms following initial discharge ( = 0.001) and were less likely to have a symptom resolution within 1 year ( < 0.0001). Neonates and infants were significantly more likely to receive conservative interventions and to sustain calvarium and skull base fractures ( < 0.0001).
This study identifies differences in pediatric age groups related to transfers, admittance, fracture type, management, and outcomes. Our data suggests adolescent patients may experience a higher incidence of residual symptoms with lower levels of symptom resolution within 1 year. Further investigation into these differences may elicit optimized methods of fracture management in pediatric age groups and allow for effective, individualized care with improved long-term outcomes.
回顾性病历审查。
与成人相比，小儿面部骨折的管理存在独特的考量因素。本研究旨在提供一个独特的视角，探讨北卡罗来纳州两家一级创伤中心在损伤机制、面部骨折类型以及骨折干预和管理之间的相关性，以确定针对该患者群体的最佳管理方案。
对2020年1月至2022年12月期间在阿特里姆健康韦克福里斯特浸礼会医疗中心和阿特里姆健康夏洛特医疗中心就诊的年龄小于18岁的小儿面部创伤患者进行了一项经机构审查委员会批准的回顾性病历审查。收集了患者人口统计学、损伤机制、面部骨折、干预措施和结果的数据。
在2977例小儿面部创伤患者中，582例患者在受伤时至少有1处面部骨折。青少年从外部机构转诊并入院接受进一步治疗的可能性显著较低（P = 0.002）。青少年在初次出院后残留症状水平较高（P = 0.001），且在1年内症状缓解的可能性较小（P < 0.0001）。新生儿和婴儿接受保守干预以及发生颅骨和颅底骨折的可能性显著更高（P < 0.0001）。
本研究确定了小儿不同年龄组在转诊、入院、骨折类型、管理和结果方面的差异。我们的数据表明，青少年患者可能残留症状的发生率较高，且在1年内症状缓解水平较低。对这些差异进行进一步研究可能会得出小儿年龄组骨折管理的优化方法，并实现有效、个性化的护理，改善长期预后。
