Current opinion in otolaryngology & head and neck surgery
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Curr Opin Otolaryngol Head Neck Surg · Aug 2009
ReviewContemporary management of pediatric facial trauma.
Facial fracture management is often complex and demanding, particularly within the pediatric population. Although facial fractures in this group are uncommon relative to their adult counterparts, a thorough understanding of issues relevant to pediatric facial fracture management is critical to optimal long-term success. ⋯ In this review of modern management of the pediatric facial trauma patient, several issues germane to pediatric facial fractures are discussed. Thorough ophthalmologic and dental/occlusive examinations must be undertaken. Conservative management is optimal for many injuries, as the pediatric fracture is typically not as severe as those seen in the adult facial skeleton. When wiring the jaw to allow for noninvasive fixation, treatment time must be short in order to avoid TMJ ankylosis. Rigid fixation is indicated in the rare comminuted, displaced fracture; when employed, the surgeon must use small plates and screws, and avoid injury to developing teeth. These are challenging cases, but with appropriate knowledge and understanding, they can be appropriately managed.