Pediatric Maxillofacial Fractures: Patterns of Injury, Surgical Indications, and Treatment Outcomes - A Five-Year Retrospective Study

Q: What clinical features make pediatric craniofacial fractures different from adult facial trauma?

They reflect distinct anatomical and developmental factors, including active growth centers and age-related biomechanics, which create specific diagnostic and therapeutic challenges.

Q: Which injury type was identified as an independent predictor of operative treatment?

Orbital floor fractures were the only independent predictor of surgical (operative) treatment.

Q: How did the study period relate to changes during the COVID-19 pandemic?

No significant changes in etiology or fracture distribution were observed during the COVID-19 pandemic.

Sep 30, 2026

Uploaded by Danger Angel

Pediatric craniofacial fractures represent a distinct clinical entity driven by unique anatomical and developmental features that separate them from adult facial trauma, despite their relative rarity. A retrospective observational study analyzed patients aged 0–17 treated for craniofacial fractures between 2020 and 2024, assessing demographics, mechanisms, fracture distribution, treatment modality, and associated injuries. Ninety-eight patients were included; midfacial fractures predominated, and orbital floor fractures independently predicted operative management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Introduction

Clinical significance and key differences from adults

Anatomical and physiological factors

Treatment principles and age-dependent etiology

Article Pediatric Maxillofacial Fractures: Patterns of Injury, Surgical Indications, and Treatment Outcomes: A Five-Year Retrospective Study Krzysztof Ga˛siorowski 1, *, Weronika Michalik 2, Jakub Bargiel 1, Tomasz Marecik 1, Julia Mia´skiewicz 2, Miłosz Saryusz-Romiszewski 3, Grayna Wyszy ´nska-Pawelec 1 and Michał Gontarz 1 Academic Editor: Eiji Tanaka and Giovanni Salzano Received: 25 October 2025 Revised: 4 December 2025 Accepted: 17 December 2025 Published: 19 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Cranio-Maxillofacial Surgery, University Hospital, Jagiellonian University Medical College, Jagiellonian University, 30-688 Cracow, Poland; [jakub.bargiel@uj.edu.pl](jakub.bargiel@uj.edu.pl) (J.B.); [tomasz.marecik@uj.edu.pl](tomasz.marecik@uj.edu.pl) (T.M.); [grazyna.wyszynska-pawelec@uj.edu.pl](grazyna.wyszynska-pawelec@uj.edu.pl) (G.W.-P.); [michal.gontarz@uj.edu.pl](michal.gontarz@uj.edu.pl) (M.G.) 2 Students’ Scientific Group, Department of Cranio-Maxillofacial Surgery, University Hospital, Jagiellonian University Medical College, Jagiellonian University, 30-688 Cracow, Poland; [weronika.michalik@student.uj.edu.pl](weronika.michalik@student.uj.edu.pl) (W.M.); [julia.miaskiewicz@student.uj.edu.pl](julia.miaskiewicz@student.uj.edu.pl) (J.M.) 3 Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Jagiellonian University, 30-663 Cracow, Poland; [milosz.saryusz-romiszewski@uj.edu.pl](milosz.saryusz-romiszewski@uj.edu.pl) * Correspondence: [krzysztof.gasiorowski@uj.edu.pl](krzysztof.gasiorowski@uj.edu.pl); Tel.: +48-12-4002800 Abstract Background: Pediatric craniofacial fractures represent a distinct clinical entity characterized by unique anatomical and developmental factors that differentiate them from adult facial trauma. Despite their relative rarity, these injuries pose diagnostic and therapeutic challenges due to the presence of active growth centers and the potential for long-term functional and esthetic sequelae. Methods: A retrospective observational study was conducted among pediatric patients aged 0–17 years treated for craniofacial fractures between 2020 and 2024 at the Department of Cranio-Maxillofacial Surgery, University Hospital in Kraków, Poland. Demographic data, injury mechanisms, fracture distribution, treatment modality, and associated injuries were analyzed. Multivariate logistic regression was applied to identify predictors of surgical intervention. Results: Ninety-eight patients met the inclusion criteria. The mean age was 12 years, with a male predominance. Midfacial fractures were most common, with orbital floor fractures representing the single most frequent injury. Surgical management was performed in 72 cases, predominantly using the transconjunctival approach and autologous bone grafting. Orbital floor fractures were identified asthe only independent predictor of operative treatment (p < 0.05) . Central nervous system trauma was the most frequent concomitant injury. No significant changes in etiology or fracture distribution were observed during the COVID-19 pandemic. Conclusions: Pediatric craniofacial trauma follows a reproducible, age-and mechanism-dependent pattern. Effective management requires individualized, growth-preserving, and function-oriented treatment strategies. Standardization of care protocols and multicenter prospective studies are essential to optimize outcomes and develop evidence-based, age-specific guidelines for the management and prevention of pediatric facial fractures. Keywords: pediatric craniofacial trauma; facial fractures; epidemiology; maxillofacial surgery 1. Introduction Pediatric craniofacial fractures represent a distinct clinical entity that differs substantially from adult facial trauma

FAQs

What clinical features make pediatric craniofacial fractures different from adult facial trauma?

They reflect distinct anatomical and developmental factors, including active growth centers and age-related biomechanics, which create specific diagnostic and therapeutic challenges.

Which injury type was identified as an independent predictor of operative treatment?

Orbital floor fractures were the only independent predictor of surgical (operative) treatment.

How did the study period relate to changes during the COVID-19 pandemic?

No significant changes in etiology or fracture distribution were observed during the COVID-19 pandemic.

Sep 30, 2026

Uploaded by Danger Angel