The protected childhood environment and the anatomy of the craniofacial skeleton largely protect children from experiencing facial fractures. However, when major trauma to the head and face is sustained, an oblique pattern of fractures has been observed, distinct from those common in adults and explicable in terms of the anatomic differences between the child's and the adult's head and face. This difference in pattern of facial fracturing is relevant in terms of the examination, investigation and treatment of the primary injury, and prevention of any subsequent facial growth disturbances.