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Abstract
Background:
Pediatric facial fractures, though less frequent than in adults, can significantly affect facial growth, function, and aesthetics. The epidemiology and patterns of these injuries vary by age and environment. Limited data exist for Pakistani children, particularly comparing preschool- and school-aged groups.
Objectives:
To determine the frequency, etiology, and patterns of facial fractures in preschool and school-aged children presenting to a tertiary healthcare hospital in Karachi, Pakistan.
Methods:
A descriptive cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery, PNS Shifa Hospital, Karachi, between 2024 and 2025. A total of 137 children with facial fractures aged 1–16 years were enrolled using non-probability consecutive sampling. Children were stratified into preschool (1–5 years) and school-aged (6–16 years) groups. Demographic data, etiology of trauma, and fracture patterns were recorded following clinical and radiological evaluation (orthopantomogram, periapical radiographs, and CT scans with 3D reconstruction). Data were analyzed using SPSS version 20. Chi-square and Fisher’s exact tests were applied, with p ≤ 0.05 considered statistically significant.
Results:
Of the 137 patients, 52 (38%) were ≤5 years and 85 (62%) were >5 years, with a male-to-female ratio of approximately 2:1 (mean age 7.8 ± 2.4 years). Road traffic accidents were the leading cause of injury (45 cases; 32.8%), followed by falls (40; 29.2%) and sports-related injuries (32; 23.4%). Dentoalveolar fractures were the most common pattern (55 cases; 40.1%), followed by mandibular (28; 20.4%) and zygomatic (18; 13.1%) fractures. In children ≤5 years, mandibular fractures and falls predominated, whereas in children >5 years, dentoalveolar and zygomatic fractures were more frequent, mainly due to RTAs and sports injuries.
Conclusion:
Pediatric facial fractures in this Pakistani cohort showed a male predominance, with dentoalveolar and mandibular fractures being most frequent. Road traffic accidents were the leading cause overall, while falls were more common in younger children. The differing etiologies and fracture patterns between age groups underscore the need for targeted preventive measures, including traffic safety, playground improvements, and protective sports gear.