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Orbital trapdoor fracture in children

Kyung-Chul Yoon1, Man-Seong Seo, Yeoung-Geol Park

  • 1Department of Ophthalmology, Chonnam National University Hospital, Gwang-ju, Korea. ophyoon@hanmail.net

Journal of Korean Medical Science
|December 17, 2003
PubMed

Insights

Early surgical intervention for pediatric orbital trapdoor fractures significantly improves outcomes. Prompt surgery within five days leads to faster recovery and better resolution of ocular motility restrictions in children.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Trauma Surgery

Background:

  • Orbital trapdoor fractures are a specific type of orbital fracture predominantly seen in pediatric patients.
  • These fractures can lead to entrapment of orbital tissues, causing significant clinical symptoms.

Purpose of the Study:

  • To evaluate clinical symptoms, fracture findings, and surgical outcomes in children with orbital trapdoor fractures.
  • To determine the optimal timing for surgical intervention to improve ocular motility.

Main Methods:

  • Retrospective analysis of 44 pediatric patients (<18 years) with pure orbital trapdoor fractures.
  • Analysis of 36 surgically treated patients, focusing on time to surgery, improvement duration, and ocular motility recovery.

Main Results:

  • Surgical intervention within 5 days showed a median improvement time of 3.5 days, compared to 18 and 50 days for later surgeries (p=0.03).
  • Early surgery (within 5 days) resulted in a greater mean reduction in supraduction limitation at 1 month postoperatively (3.50) versus later surgeries (2.11 and 1.67) (p=0.04).

Conclusions:

  • Orbital trapdoor fractures in children require careful diagnosis using CT scans and clinical assessment for entrapment.
  • Early surgical repair within 5 days is recommended for children with severe ocular motility limitation to achieve faster and superior postoperative improvement.

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