Patterns of frontobasal and frontosinal fractures in children and teenagers relative to developmental stage of the facial skeleton.

OBJECTIVES

To clarify the patterns of frontobasal and frontosinal fractures in children and teenagers and to analyze whether the patterns relate to developmental stage of the facial skeleton.

DESIGN

Retrospective study.

SETTING

Level I trauma center in Bern, Switzerland.

PATIENTS: Forty-three consecutive patients aged 18 years or younger with fracture of the frontal skull base.

MAIN OUTCOME MEASURES: Age at the time of injury and site, type, and degree of displacement among frontobasal and frontosinal fractures.

RESULTS

The orbital roof was the most common frontobasal fracture site (86.0% [37 of 43]), and a combined lateral and central frontobasal fracture was the most common fracture type (55.8% [24 of 43]). Frontosinal fractures were observed in 46.5% of patients (20 of 43). Displacement or communitation of frontobasal fractures occurred in 46.5% of patients (20 of 43) and of frontosinal fractures in 70.0% (14 of 20). Isolated central frontobasal fractures were significantly more frequent in teenagers than in children aged 6 years or younger, but isolated lateral frontobasal fractures were significantly more frequent in children aged 6 years or younger than in teenagers (P = .02 for both). Dislocation or communition of frontosinal fractures was significantly more frequent in teenagers than in children aged 6 years or younger (P = .04).

CONCLUSION

Frontobasal fracture patterns are related to age, reflecting their correlation with the developmental phase of the facial skeleton, particularly size and degree of pneumatization of the paranasal sinuses.