Orbital fractures in children: clinical features and management outcomes

Surgical treatment of enophthalmos in children and adolescents with pure orbital blowout fracture

“…Numerous studies [1][2][3][4][5] have reported that treatment outcomes for children depend on the time from injury to surgery. The prevailing opinion is that surgical treatment should be performed as soon as possible, principally because trapdoor fracture leads to muscle ischemia and, thus, irreversible change to eye position and movement.…”

“…Although outcomes were slightly better for earlier surgery, the difference was not significant. Cobb et al [5] found that bone elasticity in children was a factor in trap door fractures. Baek et al [1] and Wei and Durairaj [17] reported that this is the most common type of orbital fracture in children and accounts for 27% to 93% of all pediatric orbital fractures.…”

“…Baek et al [1] and Wei and Durairaj [17] reported that this is the most common type of orbital fracture in children and accounts for 27% to 93% of all pediatric orbital fractures. White-eyed blowout fracture is a unique pediatric orbital fracture in which ocular hematoma, subconjunctival ecchymosis, and enophthalmos are absent; [5] however, a reduction in eyeball mobility, especially during upgaze, and general symptoms such as nausea, vomiting, and bradycardia caused by the eye-heart reflex (the Aschner-Dagnini reflex) may occur. Radiological findings for white-eyed fracture may be limited [9] and include fissure of the fracture or a trap door fracture, ie, the typical "green stick" fracture.…”

“…Orbital fractures constitute 3% to 50% of facial skull injuries [1][2][3][4][5]. Pediatric orbital fractures differ clinically from those in adults because of differences in the structure of the bone, the proportions between the facial and cerebral skull, and development of the paranasal sinuses [5].…”

“…Orbital fractures constitute 3% to 50% of facial skull injuries [1][2][3][4][5]. Pediatric orbital fractures differ clinically from those in adults because of differences in the structure of the bone, the proportions between the facial and cerebral skull, and development of the paranasal sinuses [5]. The classical triad of symptoms for blowout fracture in adults is double vision, enophthalmos, and impairment of sensation in the infraorbital area.…”