Clinical analysis of pediatric orbital blowout fractures

Objective To analysis the features of pediatric orbital blowout fractures and seek the effective therapeutics. Design Retrospective case series. Participants 59 pediatric patients with the orbital blowout fractures, younger than 12 years old. Methods The position of the eyeball, the degree of enophthalmos, the movement of eyeball and diplopia were observed before and after therapy. The position and size of fractures and the embedded musculi oculi were observed by CT scan. 5 of 59 eyes were evaluated by traction and the others by surgical intervention. Main Outcome Measures The position of the eyeball, the degree of enophthalmos, the movement of eyeball and diplopia before and after therapy. Results All 59 patients existed diplopia and restrictive eyeball movement, 1 eye with mild enophthalmos. CT showed orbital fractures in all eyes, 57 eyes with orbital floor fractures, 2 eyes orbitonasal fractures and both two kinds of fractures happened in 1 eye. After 1 to 3 times traction, the diplopia disappeared in 5 cases. After surgical intervention, the diplopia disappeared within 8 months in 54 cases. Diplopia disappeared within 1 month in the cases whose operations were performed within 1 week. Conclusions The pediatric orbital blowout fractures more often happen in the orbital floor. Enophthalmos is infrequence and mild. Cases that have serious obstacle of eye movement and the embedded musculi oculi should be operated as soon as possible. The earlier operation, the quicklier disappear of diplopia. It's effective to cure some mild pediatric orbital fractures by traction.