Change in the pattern of paediatric maxillofacial fractures seen in Kaduna, Northern Nigeria.

Trauma is the leading cause of morbidity and mortality among children worldwide. 1 However, in comparison with adults, maxillofacial fractures in children are relatively uncommon due to physiological and environmental factors. Between 4% and 12% of all maxillofacial fractures occur in children. 2-5 The reasons for the wide disparity in incidence rates include differences in age limit of the pediatric population studied, types of injuries classified and the socio-economic status of the population which influences access to health care facilities. Nigeria, like many developing countries in Africa has witnessed tremendous socio-economic and demographic changes in the past 20years. This has altered the pattern of some health conditions. Since the last published series on pediatric maxillofacial fractures from our center in 1980, 2 to our knowledge no recent review from our center has been presented. This is important as our center was the first oral/maxillofacial care center in northern Nigeria and remains an important tertiary care facility in the region. The aim of this report was to evaluate the current pattern of maxillofacial fractures in the urban Northern Nigerian pediatric population as seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria for comparison with other Nigerian and international records. A retrospective survey of cases of maxillofacial fractures seen between 1991 and 2000 at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, and Kaduna, Nigeria was undertaken. Children aged 15 years and below were selected out for further study. Materials reviewed include case notes, radiological reports and theater records. Information retrieved for analyses were age, sex, cause of fracture, site (s) of facial fracture, associated injuries and treatment. Poor return for follow-up made it impossible to review complications. Mandibular fractures were classified as anterior that is, between the canine teeth, posterior – from canine to end of occlusion, angle, ramus, condyle, dentoalveolar and coronoid types. Middle third fractures were classified as Le Fort type, Zygomatic complex and nasal complex types. Out of 443 cases of maxillofacial fractures seen within the study period, 21 (4.7%) were children aged 15years and below. There was a bimodal peak age of incidence at ages 9-10years old (n = 7, 33.3%) and 13-15years old (n = 8, 38%). The mean age of the children was 11.5 ± 2.6years (median age 11years) with no child below 6years of age. There were 15 males and 6 females. The main etiological factors were falls 12, road crashes 6, and fights 2. A total of 29 maxillofacial fractures were seen in the 21 patients giving a fracture to patient ratio of 1.4:1. Five patients (24%) had fractures of the middle-third and mandible but fractures most were mandibular only (14, 66%) while the rest were in the middle-third of the face alone (10). Treatment of cases is shown in Table 1. No associated injuries were recorded in the 21 children with maxillofacial fractures seen in this study.