Abstract 17: 40 LE FORT FRACTURES IN CHILDREN - DO THEY EXIST?

INTRODUCTION: Currently, it is unclear whether Le Fort-type fractures occur in the pediatric population. The purpose was to examine the etiology, incidence, and fracture patterns of children with severe facial trauma associated with pterygoid-plate fractures. MATERIALS AND METHODS: We reviewed all pediatric patients with pterygoid-plate and facial fractures that presented to our institute from 1990–2013. Patient charts and radiological records were reviewed for demographics and fracture characteristics. Patients were further categorized by dentition age, frontal sinus development, and mechanism of injury. Facial fracture patterns were categorized into two groups: group A, non Le Fort-type fractures, group B, Le Fort-type fracture patterns. Univariate methods were employed to compare groups. RESULTS: Of the 24 patients identified, the majority presented with typical Le Fort-type fracture patterns (group B; 66%). Of these 24 children, 58% had skull fractures, 46% had intracranial trauma, and 17% developed meningitis. Age was significantly different between group A and group B (mean 5.9 vs 9.9; p=0.009). No significant differences in injury severity score, rate of operative repair, and length of stay were found between groups. 10 children with deciduous and mixed dentition presented with Le Fort-type fracture patterns (group B). Of these children, 6 did not have a developed frontal sinus. CONCLUSION: Our study provides evidence that children with deciduous and mixed dentition do present with complete Le Fort-type fractures. Although non Le Fort-type fractures may be more common in younger children, mature facial skeleton development is not a prerequisite for the development of Le Fort-type fractures.