Characteristics and Causes of Facial Bone Fracture of Preschoolers in Taiwan

學齡前幼童顏面骨骨折分析

Chia-Fang Chen(陳嘉芳) ； Yu-Ying Chu(朱育瑩) ； Chien-Tzung Chen(陳建宗) ； Han-Tsung Liao(廖漢聰)

《臺灣整形外科醫學會雜誌》 32卷1期 (2023/03) Pp. 27-38

摘要

Background: Facial bone fracture is not common in preschoolers. Characteristics of fracture are different in pediatric cases due to anatomical differences. The treatment of this fracture remains under debate. Aim and Objectives: We provided a comprehensive overview of facial fractures and management strategies in preschoolers in Taiwan to optimize the outcomes. Materials and Methods: We included 21 patients aged 0-6 years with facial bone fractures admitted to our hospital from 2008 to 2011. All patients underwent primary and secondary surveys and received resuscitation at our emergency room. Relevant radiographs such as head and neck computed tomography were taken. Data were collected from medical records and clinical and radiographs. Results: The major cause of fracture was road traffic accidents (particularly motorcycle accidents), followed by falls. Frontal bone fracture was the most common fracture type (33.3%), followed by orbital wall fracture (25%). Associated injury occurred in 13 children. Patients with mandibular fractures were treated with surgery, whereas those with frontal or orbital fractures were mainly treated conservatively. Conclusion: Motor vehicle collision was the most common cause of pediatric facial bone fracture, with transport by motorcycle and not using a safety seat being the major causes. Road safety rules should be more strongly enforced to protect young children.

關鍵字

pediatric ； preschoolers ； facial bone ； fracture

並列摘要

背景：顏面骨骨折在學齡前幼童並不常見。由於解剖構造上的差異，幼童的顏面骨骨折特徵和大人並不相同，治療方式目前也存在討論空間。目的及目標：了解台灣學齡前幼童顏面骨骨折特徵、受傷成因、臨床症狀及治療，找出最佳預防機制。材料及方法：從2008年至2011年，總共21位0－6歲的學齡前幼童因顏面骨骨折在本院急診接受評估及檢查，並在本院住院接受治療；我們收集病患之年齡、受傷後生命徵象、顱顏影像學檢查及住院處置等資料進行研究。結果：學齡前幼童最常發生顏面骨骨折的原因為交通事故，尤其是機車相關交通事故，其次是跌傷。骨折最常見的部位在額骨（33.3%），而第二常見的部位是眼眶骨（25%）。在21位病人中，有13位病人同時合併其他部位受傷。大部分下顎骨骨折病患接受了手術治療，但額骨骨折或眼眶骨骨折，多數採取保守觀察。結論：交通事故是最常造成學齡前幼童顏面骨骨折的原因，包括無適當防護下的使用機車載運幼童及未使用汽車安全座椅。我們需要更強力的宣導交通規則來保護幼童，減少顏面骨骨折事件。