How Do Le Fort–Type Fractures Present in a Pediatric Cohort?

Purpose: Le Fort–type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. Patients and Methods: We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010. Patient charts and radiologic records were reviewed for demographic and fracture characteristics. Patients were categorized into 2 groups as per facial fracture pattern: non–Le Fort–type fractures (group A) and Le Fort–type fractures (group B). Other variables including dentition age, frontal sinus development, mechanism of injury, injury severity, and concomitant injuries were recorded. Univariate methods were used to compare groups. Results: We identified 24 children; 25% were girls, and 20.8% were of nonwhite race. Most presented with Le Fort–type fracture patterns (group B, 66.7%). Age was significantly different between group A and group B (mean, 5.9 years and 9.9 years, respectively; P =.009). No significant differences in Injury Severity Score, rate of operative repair, and length of stay were found between groups. Conclusions: Most children with severe facial fractures and pterygoid plate fractures presented with Le Fort–type fracture patterns in our cohort. The mean age of children with Le Fort–type fractures was greater than in those with non–Le Fort–type patterns. However, Le Fort–type fractures did occur in younger children with deciduous and mixed dentition.