Plast Reconstr Surg. 2022 Oct 18. doi: 10.1097/PRS.0000000000009783. Online ahead of print.
ABSTRACT
BACKGROUD: Despite clinical concerns associated with pediatric traumatic brain injuries (TBIs), they remain grossly underreported. This is the first retrospective study to characterize concomitant pediatric TBI and CMF trauma patients, including frequency, presentation, documentation, and outcomes.
METHODS: An IRB-approved retrospective cohort study was performed to identify all pediatric patients presenting with CMF fractures at a high volume, tertiary trauma center between the years 1990 and 2010. Patient charts were reviewed for demographic information, presentation, operative management, length of stay, mortality at two years, dentition, CMF fracture patterns, and concomitant TBIs. Data was analyzed using two-tailed Student’s t-tests and chi square analysis. A P value ≤ 0.05 was considered statistically significant.
RESULTS: Of the 2966 pediatric CMF trauma patients identified and included for analysis (mean age of 7 ± 4.7 years old, predominantly Caucasian [59.8%], and male [64.0%]), 809 had concomitant TBI (frequency of 27.3%). Only 1.6% of the TBI cases were documented in charts. Mortality at two years, length of stay in hospital, and time to follow up significantly increased from mild to severe TBIs. Concomitant TBI were more common with skull & upper third fractures than CMF trauma without TBI (81.8% vs 61.1%, P < 0.05).
CONCLUSIONS: Concomitant TBI injuries were present in a significant number of pediatric CMF trauma cases but was not documented for most cases. Craniomaxillofacial surgeons should survey all pediatric CMF trauma patients for TBI and manage with neurology and/or neurosurgery teams. Future prospective studies are necessary to characterize and generate practice guiding recommendations.
PMID:36251865 | DOI:10.1097/PRS.0000000000009783
