A Five-year Study (2014-2019) of the Etiology and Prevalence of Maxillofacial Fractures in Children Referring to Imam Khomeini Hospital of Ahvaz (2014-2019)

Document Type : Original Article


1 dentist.

2 Assistant Professor of Department of oral and maxillofacial department, dentistry faculty, Ahvaz University of Medical Sciences, Ahvaz, Iran



Background and Objectives Facial fractures in children are unusual injuries that make up to 15% of facial fractures. Although maxillofacial trauma is more common in children than in adults, the incidence of facial fractures is lower. Epidemiology and etiology of facial fractures vary from country to country, and depend largely on economic group, culture, and geographical area. Maxillofacial fractures are the most common type of facial fractures. Subjects and Methods This 5-year (2014-2019) retrospective observational-descriptive and cross-sectional study was performed among pediatric patients (1 to 12 years old) referring to the maxillofacial surgery department of Imam Khomeini Hospital in Ahvaz (due to trauma and jaw fracture). The indicators included age, sex, time, cause of fracture, fracture position, type of fracture, and existence of accompanying fracture.
Results Based on the results obtained in this study, 32.7% of the participants were girls and 67.3% were boys. The most common causes of jaw fractures were MVA (63.4%) and falling (25%). The highest frequency of jaw fracture due to trauma (17.3%) was at the age of 12 years followed by the ages of 9 and 10 years (15.4%). The highest rate of jaw fracture due to trauma in children (1 to 12 years) was in summer (32.7%). The results of this study show that the most common type of fractures was in the mandible (87.5%) which was more reported in males. The most common treatments used were close reduction (67.3%) and ORIF (26.9%). Conclusion The results of this study show that the most common type of fractures are in the mandible and more in men. The highest rate of fractures was reported between the ages of 8 to 12 years. This study showed that the highest percentages of the cause of jaw fractures were MVA and falling, respectively. Also, the highest percentage of hydrotherapy methods used were close reduction and ORIF.


Main Subjects

[1] Wymann NM, Hölzle A, Zachariou Z, Iizuka T. Pediatric craniofacial trauma. Journal of oral and maxillofacial surgery. 2008 Jan 1;66(1):58-64. [10.1016/j.joms.2007.04.023] [PMID]
[2] Goodenough CJ, Moffitt JK, D’Arcy JW, Cantor AD, Nguyen PD, Teichgraeber JF, Greives MR. Cervical spine injuries in pediatric maxillofacial trauma: an under-recognized problem. Journal of Craniofacial Surgery. 2020 May 1;31(3):775-7. [10.1097/ SCS. 0000000000006111] [PMID]
[3] Grunwaldt L, Smith DM, Zuckerbraun NS, Naran S, Rottgers SA, Bykowski M, Kinsella C, Cray J, Vecchione L, Saladino RA, Losee JE. Pediatric facial fractures: demographics, injury patterns, and associated injuries in 772 consecutive patients. Plastic and reconstructive surgery. 2011 Dec 1;128(6):1263-71. [10.1097/ PRS.0b013e318230c8cf] [PMID]
[4] Siy RW, Brown RH, Koshy JC, Stal S, Hollier Jr LH. General management considerations in pediatric facial fractures. Journal of Craniofacial Surgery. 2011 Jul 1;22(4):1190-5. [10. 1097/SCS.0b013e31821c0cf9] [PMID]
[5] Monnazzi MS, Gabrielli MA, Gabrielli MF, Trivellato AE. Treatment of mandibular condyle fractures. A 20‐year review. Dental Traumatology. 2017 Jun;33(3):175-80. [10.1111/edt. 12326][PMID]
[6] Amarista Rojas FJ, Bordoy Soto MA, Cachazo M, Dopazo JR, Vélez H. The epidemiology of mandibular fractures in Caracas, Venezuela: Incidence and its combination patterns. Dental traumatology. 2017 Dec;33(6):427-32.[:10.1111/edt.12370] [PMID]
[7] Andrew TW, Morbia R, Lorenz HP. Pediatric facial trauma. Clin Plast Surg. 2019; 46(2):239-47. [10.1016/j.cps.2018.11.008] [PMID]
[8] Lee KH. Epidemiology of mandibular fractures in a tertiary trauma centre. Emergency medicine journal: EMJ. 2008 Sep 1; 25(9):565. [10.1136/emj.2007.055236] [PMID]
[9] Morris C, Bebeau NP, Brockhoff H, Tandon R, Tiwana P. Mandibular fractures: an analysis of the epidemiology and patterns of injury in 4,143 fractures. Journal of Oral and Maxillofacial Surgery. 2015 May 1;73(5):951-e1. [10.1016/j. joms.2015.01.001] [PMID]
[10] Haug RH, Foss J. Maxillofacial injuries in the pediatric patient. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2000 Aug 1;90(2):126-34. [10.1067/moe. 2000.107974] [PMID]
[11] Hogg NJ, Stewart TC, Armstrong JE, Girotti MJ. Epidemiology of maxillofacial injuries at trauma hospitals in Ontario, Canada, between 1992 and 1997. Journal of Trauma and Acute Care Surgery. 2000 Sep 1;49(3):425-32.[10.1097/00005373-2000 09000-00007] [PMID]
[12] Ferreira PC, Barbosa J, Braga JM, Rodrigues A, Silva ÁC, Amarante JM. Pediatric facial fractures: A review of 2071 fractures. Ann Plast Surg. 2016; 77(1):54-60. [10.1097/SAP. 0000000000000346] [PMID]
[13] Singhal R, Singh V, Bhagol A, Agrawal A, Kumar P. Pediatric maxillofacial injuries–If a new look is required?. International Journal of Pediatric Otorhinolaryngology. 2013 Aug 1;77(8): 1333-6. [10.1016/j. ijporl.2013.05.028] [PMID]
[14] Zimmermann CE, Troulis MJ, Kaban LB. Pediatric facial fractures: recent advances in prevention, diagnosis and management. International journal of oral and maxillofacial surgery. 2005 Dec 1;34(8):823-33. [10.1016/j.ijom.2005.06. 015] [PMID]
[15] Zimmermann CE, Troulis MJ, Kaban LB. Pediatric facial fractures: recent advances in prevention, diagnosis and management. International journal of oral and maxillofacial surgery. 2005 Dec 1;34(8):823-33. [10.1016/j.ijom.2005.06. 015] [PMID]
[16] Dodson TB. Mandibular fractures in children. OMS Knowledge update. 1995;1(part II):95-107.[LInk]
[17] Kaban LB. Facial trauma I: Midface fractures. In: Kaban LB, Ed. Pediatric Oral and Maxillofacial Surgery. Philadelphia, PA: W.B. Saunders.1990;209-232.
[18] Sharma S, Vashistha A, Chugh A, Kumar D, Bihani U, Trehan M, Nigam AG. Pediatric mandibular fractures: a review. International Journal of Clinical Pediatric Dentistry. 2009 May; 2(2):1. [10.5005/jp-journals-10005-1022] [PMID]
[19] Glazer M, Joshua BZ, Woldenberg Y, Bodner L. Mandibular fractures in children: analysis of 61 cases and review of the literature. International journal of pediatric otorhinolaryngology. 2011 Jan 1;75(1):62-4. [10.1016/j.ijporl.2010.10.008] [PMID]
[20] Zimmermann CE, Troulis MJ, Kaban LB. Pediatric facial fractures: Recent advances in prevention, diagnosis and management. Int J Oral Maxillofac Surg. 2006; 35(1):2-13. [Link]
[21] Souza DF, Santili C, Freitas RR, Akkari M, Figueiredo MJ. Epidemiology of children's facial fractures in the emergency room of a tropical metropolis. Acta Ortopédica Brasileira. 2010;18:335-8.[Link]
[22] Cossio PI, Galvez FE, Perez JL, Garcia-Perla A, Guisado JM. Mandibular fractures in children: A retrospective study of 99 fractures in 59 patients. International journal of oral and maxillofacial surgery. 1994 Dec 1;23(6):329-31. [10.1016/ S0901-5027(05)80047-5] [PMID]
[23] Ghosh R, Gopalkrishnan K, Anand J. Pediatric Facial Fractures: A 10-year Study. J Maxillofac Oral Surg. 2018; 17(2):158-63. [10.1007/s12663-016-0965-8] [PMID]
[24] ORAL AND MAXILLOFACIAL SURGERY third edition VOLUME1 Profession and Practice of Oral and Maxillofacial Surgery Anesthesia and Pain Control Dentoalveolar Surgery Implant Surgery VOLUME EDITOR Raymond J. Fonseca, DMD Private Practice Oral and Maxillofacial. 316AD. 400 p.
[25] Kim SH, Lee SH, Cho PD. Analysis of 809 facial bone fractures in a pediatric and adolescent population. Arch Plast Surg. 2012; 39(6):606-11. [10.5999/aps.2012.39.6.606] [PMID]
[26] Khan SR, Khan ZA, Hanif S, Riaz N, Warraich RA. Patterns of facial fractures in children. Br J Oral Maxillofac Surg. 2019; 57(10):1009-13. [10.1016/j.bjoms.2019.08.020] [PMID]
[27] Shah AA, Ali Shah A, Salam A. Pattern and management of mandibular fractures: A study conducted on 264 patients. Pakisthan Oral Dent J. 2007;27(1):103-5. [Link]
[28] Khan MA, Ishfaq M, Akhtar M, Rana SAA, Kashif M. Frequency of paediatric facial trauma in a tertiary care dental hospital. Int Surg J. 2017; 5(1):310-4. [10.18203/2349-2902.isj20175917]5
Scientific Medical Journal
January & February 2024. Vol 22. No 6
Ali Kazemi M, et al. Etiology and Prevalence of Maxillofacial Fractures in Children. JSMJ. 2024; 22(6):778-789
[29] Vyas RM, Dickinson BP, Wasson KL, Roostaeian J, Bradley JP. Pediatric facial fractures: Current national incidence, distribution, and health care resource use. J Craniofac Surg. 2008;19(2):339-49. [10.1097/SCS.0b013e31814fb5e3] [PMID]
[30] Kaban LB, Troulis MJ. Pediatric Oral and Maxillofacial Surgery.Philadelphia: Saunders; 2004. [Link]
[31] Özkaya Ö, Turgut G, Kayalı MU, Uğurlu K, Kuran İ, Baş L. A retrospective study on the epidemiology and treatment of maxillofacial fractures. Ulus Travma Acil Cerrahi Derg. 2009; 15(3):262-6. [PMID]
[32] Kaura S, Kaur P, Bahl R, Bansal S, Sangha P. Retrospective study of facial fractures. Annals of maxillofacial surgery. 2018 Jan;8(1):78. [10.4103/ams.ams_73_17] [PMID]