Traumatic maxillofacial fractures appear to be less frequent and different in the pediatric than in the adult population, because of multiple elements such as the difference in the constitution of bones, more tissue elasticity, incomplete ossification in children (Chocron et al., 2019), small-sized bones, developing paranasal sinuses, the existence of growth centers, faster healing period, and possible presence of developing teeth germs [9].
Few studies compare between the maxillofacial fractures in adult and pediatric patients and most of these studies are retrospective [3, 10,11,12] and some lack the management of those patients [3, 12].
So, we studied the comparison between adult versus pediatric maxillofacial fractures in a prospective study including the management data.
In the current study, below school age (6 years), no maxillofacial fracture patients were detected. In accordance, it is estimated that < 1% of the maxillofacial trauma occur in children < 5 years old [2]. In addition, in the present study, no maxillofacial fracture was reported in patients above 60 years. This could be attributed to the limited mobility of children below skull age and patients above 60 years )retirement age) that limits their trauma.
As previously reported in the literature [1, 2, 4], in the current study, males were the main gender affected by maxillofacial fractures with high percent (95% in children and 100% in adults).
The mandibular fracture was the most commonly reported fracture in both adults and children, but there was a significantly highest incidence of mandibular fractures that occurred in children (65%) versus 38% in adults. The mandibular fracture was also the most common in agreement with most previous studies [9, 11, 13,14,15].
The cause of trauma was significantly different between adult and pediatric. In spite of that MVA is the most common cause of trauma in both adults and children, fall was the cause in 17.5% of the pediatric group and was not reported as a cause in the adult group (Table 1). Near results were also detected by Atilgan et al. [16] and Arvind et al. [13], while Jung et al. [17] and Bharadwaj [18] found that fall was the most common cause.
These etiological pattern changes differ from region to region and may be due to socioeconomic problems, social habits, the stresses of residing in large or crowded cities, etc. But the results here reflect the important extra care of preventing and care of risk of fall in children.
Surgical treatment was the main used treatment in both groups, and this may be attributed that this research was done in a tertiary hospital and so many cases were treated conservatively at the primary and secondary care hospitals and health facilities. On the other hand, maxillofacial fractures were treated conservatively more in children (20%) than in adults (4.76%). Near results were reported by Iatrou et al. [12] reported.
In the present study, OR/IF was the main operative intervention. Similarly, Daniels et al. [10] documented that OR/IF was the main treatment modality in 69.2% of patients.
We agree with Bansal et al. [19] that in pediatric patients, although closed treatment could be preferred, as it preserves the soft tissue and periosteum, displaced fractures especially with co-existing condylar fractures should be treated by OR/IF.
The basic principle of fracture treatment is reduction, fixation, immobilization, prevention of infection, and rehabilitation, with the least disability and smallest risk for the patient [3, 4]. Thus, whenever there is a displaced fracture, today, OR/IF is the standard management [4, 7].
