A Decade of Pediatric Facial Fractures: Incidence, Mechanisms, and Socioeconomic Correlates From a Single Level 1 Trauma Center

BACKGROUND: Pediatric facial fracture management is complicated by craniofacial growth, with injury patterns varying by demographic factors. This study evaluates fracture characteristics, management, and variability by age, sex, race, and socioeconomic status (SES). METHODS: A retrospective review of pediatric patients with facial fractures at a single level 1 trauma center between 2013 and 2022 was performed. Demographics, injury characteristics, fracture patterns, and management were recorded. SES was measured using area deprivation index (ADI) scores. Analyses included χ2, Student t tests, and logistic regression. RESULTS: A total of 486 patients (852 fractures) were included. Most were male (61.9%) and White (68.1%), with a mean age of 11.3 years. The most common fracture sites were orbital (27.0%), nasal (16.8%), and maxillary (15.4%), with orbital-maxillary and orbital-frontal as the most frequent combinations. Motor vehicle accidents were the leading cause across groups, while other mechanisms varied by age. Sports-related injuries were associated with orbital fractures (P=0.017). Surgical management was required in 26.1% of patients and was associated with older age (mean: 12.3 versus 11.1 y, P=0.026). Assault- and ATV-related injuries were significant predictors of surgical management (P<0.05). Higher SES was linked to more bicycle-related injuries (P<0.05), whereas lower SES was associated with more assault-related and fewer sports-related injuries (P<0.05). CONCLUSION: While demographic factors did not influence surgical management or outcomes, SES was associated with differing injury mechanisms. These findings highlight the need for targeted prevention and individualized care in pediatric facial trauma.