Traumatologie des Gesichtsschädels im Kindesalter

Zusammenfassung

Frakturen des Gesichtsschädels sind im Kindesalter aufgrund anatomischer Besonderheiten und unterschiedlicher Kausalitäten deutlich seltener als im Erwachsenenalter. Die Versorgung von sich im Wachstum befindlichen Gesichtsschädelknochen stellt den behandelnden Arzt oft vor eine große Herausforderung und setzt eine genaue Kenntnis der kindlichen Anatomie voraus. Oft bleiben mögliche spätere Wachstumsstörungen aufgrund des initialen Traumas, aber auch durch den chirurgischen Eingriff selbst schwer abzuschätzen. Kleine Patientenkollektive und die Notwendigkeit langfristiger Nachuntersuchungen erschweren zusätzlich evidenzbasierte Aussagen.

Abstract

Associated injuries are a common feature in pediatric facial fractures, which reinforce the importance of a complete initial assessment of a child with facial trauma.

Particular kinds of fracture tend to occur at specific anatomic sites in children, with the severity and extent of the fracture varying according to the patient’s age and the stage of skeletal development. The frequency of severe fractures increases with age, as does the frequency of surgically treated fractures. Maxillofacial surgical intervention is indicated only for the repair of severely displaced fractures that are likely to cause functional impairment, esthetic deformity, or both. The effect of treatment on long-term growth and development must be the cornerstone when choosing the optimal therapeutic option. While internal fixation is routinely used for adult facial trauma patients, the application of these surgical techniques in children is controversial as subperiosteal dissection might disturb the growth of the bone.

Schlüsselwörter

pädiatrische Frakturen - Unterkieferfrakturen - Gesichtsschädel - Mittelgesichtsfrakturen - Orbitabodenfrakturen - Schädelentwicklung

Key words

pediatric facial trauma - internal Fixation - maxillofacial trauma - orbital fractures - mandible fractures - facial growth

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