There are several reasons for the lower incidence of facial fractures in children: the face is smaller in relation to the rest of the head, children are less often in some situations associated with facial fractures such as occupational and motor vehicle hazards, there is a lower proportion of cortical bone to cancellous bone in childrens faces, poorly developed sinuses make the bones stronger, and fat pads provide protection for the facial bones.Head and brain injuries are commonly associated with facial trauma, particularly that of the upper face; brain injury occurs in 15–48% of people with maxillofacial trauma. Coexisting injuries can affect treatment of facial trauma; for example they  may be emergent and need to be treated before facial injuries. People with trauma above the level of the collar bones are considered to be at high risk for cervical spine injuries (spinal injuries in the neck) and special precautions must be taken to avoid movement of the spine, which could worsen a spinal injury. References
Cited texts
Jeroukhimov I, Cockburn M, Cohn S (2004). "Facial trauma: Overview of trauma care". In Thaller SR (ed.). Facial trauma. New York, N.Y: Marcel Dekker. ISBN 0-8247-4625-2. Retrieved 2008-10-19. Neuman MI, Eriksson E (2006). "Facial trauma". In Fleisher GR, Ludwig S, Henretig FM (eds.). Textbook of Pediatric Emergency Medicine. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-5074-1. Retrieved 2008-10-19. Seyfer AE, Hansen JE (2003). "Facial trauma". In Moore EE, Feliciano DV, Mattox KL (eds.). Trauma. Fifth Edition. McGraw-Hill Professional. pp. 423–24. ISBN 0-07-137069-2.
Nasal intubation, inserting an endotracheal tube through the nose, may be contraindicated in the presence of facial trauma because if there is an undiscovered fracture at the base of the skull, the tube could be forced through it and into the brain. If facial injuries prevent orotracheal or nasotracheal intubation, a surgical airway can be placed to provide an adequate airway. Although cricothyrotomy and tracheostomy can secure an airway when other methods fail, they are used only as a last resort because of potential complications and the difficulty of the procedures. A dressing can be placed over wounds to keep them clean and to facilitate healing, and antibiotics may be used in cases where infection is likely. People with contaminated wounds who have not been immunized against tetanus within five years may be given a tetanus vaccination. Lacerations may require stitches to stop bleeding and facilitate wound healing with as little scarring as possible. Although it is not common for bleeding from the maxillofacial region to be profuse enough to be life-threatening, it is still necessary to control such bleeding. Severe bleeding occurs as the result of facial trauma in 1–11% of patients, and the origin of this bleeding can be difficult to locate. Nasal packing can be used to control nose bleeds and hematomas that may form on the septum between the nostrils. Such hematomas need to be drained.