The characteristics and surgery therapy of pediatric orbital fracture

Abstract

Objective To analyze clinical features of pediatric orbital fractures and considerations in the surgery procedures.Methods A retrospective research was carried out with 15 pediatric orbital fracture patients aged from 2 to 14 years.The injury causes,clinical manifestations,accompanying symptoms,positions of orbital fracture and imaging examinations,standout of eyeballs,data of diplopia images and synoptophore examinations were analysed.Results Violence injury (10 cases),traffic accident (3 cases)and fall injury (2 cases) were main causes of orbital fracture.CT showed eight inferior orbital fractures in fifteen pediatric patients(53.3％).All of the 15 cases had diplopia,13 children among them had nausea and vomiting symptoms,and three of them had enophthalmos.All of the pediatric patients were operated.Ten days after operation,fifteen operated eyes were higher than or equal to the contralateral eyes.Diplopia disappeared in five children,alleviated in seven children and deteriorated in three children.Two months after operation,the sign of enophthalmos disappearred and the eyeballs of the two sides were symmetrical in the 15 cases.Diplopia completely disappeared in eight children,remained slightly in five children.Two children with apparent diplopia needed to be operated.Conclusion Pediatric orbital fractures are mostly orbital floor blowout fractures,ocular muscles and fascia tissues are easily entrapped in the fracture fissure.It is very important to recover normal orbital shape,separate entrapped soft tissues adequately and implant Medpor or HA reasonably.In addition,it should be paid attention by doctors and parents to recover and train the functions of injuried ocular muscles. Key words: Fracture,orbital; pediatric; Diplopia; Enophthalmos