Clinical characteristics and treatment of maxillofacial fractures in 171 children and adolescents:a single-center retrospec-tive study in Xi'an

LIU Shiwei; YU Yixuan; GUO Wenheng; KONG Youjia; LIU Hengxin; JIN Changxin; CHEN Jie; YIN Anan; ZHANG Xi

doi:10.3969/j.issn.1673-7040.2025.10.015

Abstract：Objective To analyze the epidemiological characteristics,clinical features,and treatment strategies of maxillofacial fractures in children and adolescents in the Xi'an region.Methods A retrospective analysis was conducted on the clinical data of 171 pa-tients aged ≤18 years with acute maxillofacial fractures admitted to the Department of Plastic Surgery of our hospital from January 2022 to December 2024.The patients were divided into three age subgroups:0 to 6 years,7 to 12 years,and 13 to 18 years.Demographic charac-teristics,injury causes,fracture distribution,associated injuries,and treatment methods were compared.Results Among the 171 patients,126 were male(73.7％)and 45 were female(26.3％),with a male-to-female ratio of 2.8∶1,which increased with age(reaching 4.5∶1 in the 13 to 18 years group).The majority of patients were adolescents aged 13 to 18 years(110 cases,64.3％).The top three causes of injury were traffic accidents(63 cases,36.8％),falls(43 cases,25.1％),and blows/object impacts(32 cases,18.7％).Interpersonal violence injuries(28 cases,16.4％)were only observed in patients above 7 years old,with the highest proportion in the 13 to 18 years group(22.7％).The most common fracture site was the nasal bone(101 cases,59.1％),followed by maxillary fractures(81 cases,47.4％)and mandibular frac-tures(33 cases,19.3％).Among mandibular fractures,condylar fractures accounted for 57.6％.Associated injuries included traumatic brain injury(18 cases,10.5％)and skull fracture(26 cases,15.2％).A total of 154 patients(90.1％)underwent surgical treatment,including closed reduction of nasal bone fractures(71 cases,41.5％)with an average operation time of(20.99±9.88)min and intraoperative blood loss of(1.43±1.67)ml,and open reduction and internal fixation of maxillofacial fractures(80 cases,46.8％)with an average operation time of(142.32±74.38)min and blood loss of(23.37±14.02)ml.Titanium plates were the most commonly used fixation material(82.5％),but the absorbable material usage rate reached 75.0％in the 0 to 6 years group.Seventeen cases(9.9％)did not undergo surgery,with the highest non-surgical rate observed in the 0 to 6 years group(33.3％).Conclusion Maxillofacial fractures in children and adolescents in the Xi'an region predominantly affect male adolescents,with traffic accidents and falls being the leading causes.Nasal bone fractures are the most common.Age significantly influences injury mechanisms and treatment choices,with younger children more frequently receiving absorbable materials and having a higher rate of non-surgical management.This study provides data support for formulating age-specific diagnosis.