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

Objective: 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.

Methods: Retrospective study. Methods: Level I trauma center in Bern, Switzerland. Methods: Forty-three consecutive patients aged 18 years or younger with fracture of the frontal skull base. Methods: 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).

Conclusions: 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.