Facial Trauma in Kids’ Motor Vehicle Accidents

Fortunately, most children ride in the back seat and are properly restrained when a motor vehicle accident occurs. Even so, kids can get facial trauma which can include facial fractures and soft tissue facial trauma.

Facial trauma refers to any type of injury to the upper jaw bone or face. The skin, neck, nose, sinuses, and underlying skeleton can be involved in this type of trauma. Even teeth can be affected or lost during a motor vehicle accident. Doctors can be suspicious of a facial fracture if the eyes appear to be too far apart, if there are deep lacerations or if there is bruising around the eyes. Nose bleeds or bleeding from the mouth or ear can be suspicious for a fracture.

In emergency room cases, the pediatric population with facial injuries suffers from facial fractures more than five percent of the time. If the child is five years of age or older, the primary cause of facial injuries is motor vehicle accidents. Experts say that the proper use of booster seats, seat belts and well-fitting car seats can decrease the incidence of facial fractures in children.

Facial injuries are different in children than in adults. A minor fracture in a child can lead to later significant disfigurement later in life. The face is not generally fully formed in children and a minor injury can grow to become a major disfigurement as the bones grow. Some injuries cause a delay in growth of that part of the face so that this makes recovery complicated. It may take a team of specialists to make a difference in the final outcome of a facial injury.

Facial injuries are usually discovered best on CT scan or MRI scan of the face. X-rays used to be the only way to detect these fractures but they were difficult to interpret. The new 3D detail can show which parts of the face are fractured as well as the degree of displacement. Surgery is often needed immediately in order to put the pieces of the fracture back together again. Then it takes time to heal the lacerations, swelling and bruising so the face can be normal again. Certain facial fractures can heal with conservative treatment.

The teeth can become knocked out or displaced. If the teeth are knocked out, they can be soaked in salt water and reinserted with a reasonable degree of expectation that the tooth will survive. If the teeth are misaligned, then a fracture is likely to have occurred. Fixing the fracture with wiring of the teeth together assures proper tooth alignment.

A recent study looked at the incidence of facial fractures depending on the type and manner of restraint the child had in a motor vehicle accident. Of 131,000 accidents looked at, a total of 92 children suffered a fracture to the facial area. Of these, about 2/3 were considered inappropriately strained. These kids had an almost two-fold increase in facial fractures when compared to children that had been restrained appropriately. If there was excessive excursion of the head because the torso was not restrained, the incidence of facial fractures was higher. Booster seats were particularly important to have.