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by Daniel Ravel DDS, FAAPD
MANAGEMENT OF FACIAL TRAUMA IN CHILDREN
The face allows recognition and communication among people.
No other part of the body is as aesthetically important as the face.
Facial injuries can range from a minor inconvenience to a lifetime disfigurement.
For this reason, any injury to this area requires particular care and attention during treatment.
In the United States, approximately 3 million people are treated in a hospital emergency department for traumatic
facial injuries each year.
Five percent of pediatric trauma patients have facial fractures.
Falls are the most common cause of facial fractures in children younger than 3 years of age.
After 5 years of age, the leading cause of facial fractures is motor vehicle collisions.
The nasal bones and mandible (jaw) are the two most frequent sites of facial fracture.
Mandibular fractures occur in 7.7% of children younger than 16 years of age.
An equal incidence of mandibular fractures exists between both sexes.
Trauma to the condylar growth center (the neck of the jaw) beneath the articular disk may cause delayed growth of the
affected side of the jaw.
EMERGENCY EVALUATION OF FACIAL TRAUMA:
First, perform a primary survey and assess airway, breathing and circulation.
Note that mobile fracture segments, edema (swelling), hemorrhage (bleeding), vomitus, bone fragments, and foreign bodies may
cause obstruction of the airway.
The airway is always the first priority in treatment of the trauma patient.
In any trauma patient, be sure to obtain cervical spine x-rays to rule out neck injury.
A complete set of vital signs including: temperature, pulse, blood pressure, and pulse oximetry should be obtained on every
patient.
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