Objective: The use of Computed Tomographic (CT) is common in the management of facial trauma. However, a child’s care can differ from treatment of adults. The role of facial CT will be examined and an algorithm subsequently developed. The role of plastic surgery in pediatric facial trauma will be reexamined.

Method: A 5 year review of maxillofacial pediatric trauma at an urban trauma center receiving facial CT from 1995-1999. Mechanisms of injury, GCS, restraint status, operative interventions, and timing of facial CT were reviewed.

Results: CT Scans were obtained in 83 patients’ reviewed records. 14 patients required operative intervention for their facial fractures. C-spine fracture was noted in one patient. 69 patients also had head CT. Plastic surgery was consulted in 68 patients. No consistent timing of facial radiographs was noted.

Conclusion: Plastic surgeons are an important part of the team caring for pediatric trauma patients. Ideally, consultation and physical examination should be completed before ordered radiographs. CT scanning of pediatric facial trauma is an important adjunct as plain films and physical diagnosis are significantly more challenging in children. A simple algorithm for management of Level 1 facial trauma is presented.