Surgical management of orbital wall fractures in juveniles: a European multicenter study.
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Boffano Paolo, Lahtinen Anssi, Brucoli Matteo, Ruslin Muhammad, Melle Andrea, Stathopoulos Panagiotis, Maniati Dimitra, Dediol Emil, Kos Boris, Michcik Adam, Polcyn Adam, Starch-Jensen Thomas, Mijatov Ivana, Bajkin Branislav V, Cailleaux Annabelle, Bertin Eugénie, Meyer Christophe, Louvrier Aurélien, Kopchak Andrii V, Pavlychuk Tetiana A, Herrera I Nogués Sergi, Martínez-Carrillo Ana, de Vicente Juan Carlos, Zaleckas Linas, Rastenienė Rūta, Stasiūnas Augustinas, Naberoj Jan, Prodnik Luka, Dovsak Tadej, Snäll Johanna
Аннотация
METHODS: Pediatric patients (less than 18 years) with hospitalized and surgically treated for unilateral isolated orbital blow out fractures of the orbital floor and/or the medial wall were included. The following data were recorded for each patient: gender, age, etiology of trauma, site of orbital wall fracture(s), timing of intervention, surgical approach, orbital reconstruction material/implant, post-operative complications RESULTS: A total of 51 pediatric patients (45 boys, 6 girls) with a mean age of 12.1 years were included. Most patients (43 children, 84.3%) presented with an isolated orbital floor fracture. Clinically, the most frequently observed sign was diplopia / double vision (43 patients, 84.3%). More than two thirds (68.6%) of cases were surgically treated within the first two days from injury. In 6 patients (11.8%) one or more persistent postoperative disturbances were found six months postoperatively, including diplopia in 3 subjects (5.9%), infraorbital nerve paresthesia in 2 patients (3.9%), and enophthalmos in 2 patients (3.9%).
CONCLUSIONS: The rarity of pure orbital wall fractures in pediatric patients makes it difficult to establish uniform evidence-based guidelines for their management. These injuries must also be recognized promptly, as surgical intervention may be required at a very early stage. A reasoned and individualized choice of the optimal surgical approach appears to be the most appropriate strategy for this specific type of facial fracture in the pediatric population.
CLINICAL TRIAL NUMBER: Not applicable.