Patterns And Outcomes of Paediatric Maxillofacial Fractures: A Retrospective Single-Centre Study of 1337 Patients With Review of Literature

Abstract

Background: Pediatric facial fractures pose a unique challenge due to the fragility, growth potential, and remarkable remodelling capacity of the developing maxillofacial skeleton. Traditionally, conservative and closed reduction techniques have been favoured to minimise growth disturbances. This study evaluated demographic trends, aetiologies, fracture patterns, management strategies, and long-term outcomes of pediatric facial fractures. Materials and Methods: A retrospective single-institution study was conducted using a database of 1,337 maxillofacial trauma cases. Among these, 112 pediatric patients (≤18 years) with facial fractures were identified and analysed. Data collected included demographics, aetiology, dentition stage, fracture characteristics, and treatment modalities, including conservative management, closed reduction, and open reduction with internal fixation (ORIF). Long-term follow-up assessed functional recovery, occlusal stability, and craniofacial growth remodelling. Results: A total of 112 pediatric patients were included. Condylar fractures were the most common injury pattern (22.3%, n=25), followed by dentoalveolar fractures (19.6%, n=22). Management was individualised based on patient age, fracture severity, and displacement. Conservative and minimally invasive approaches were preferred whenever feasible, while ORIF was reserved for displaced or complex fractures. Long-term follow-up demonstrated satisfactory functional recovery, stable occlusion, favourable craniofacial growth, and minimal complications. Patients treated with ORIF in appropriately selected cases also showed successful outcomes without significant growth disturbances. Conclusion: Individualised management of pediatric maxillofacial fractures, emphasising conservative treatment when appropriate and ORIF for selected complex injuries, yields favourable long-term outcomes. Careful surgical planning minimises morbidity and supports optimal functional rehabilitation and craniofacial growth, even in extensive facial trauma.