Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Area of Science:

• Ophthalmology
• Pediatric Traumatology
• Oculoplastics

Background:

• Orbital floor blowout fractures are common in children.
• Inferior rectus (IR) palsy is a potential complication, but its specific features in pediatric patients are not well-defined.

Purpose of the Study:

• To determine the incidence, clinical characteristics, and risk factors for inferior rectus palsy in pediatric patients with orbital floor blowout fractures.

Main Methods:

• Retrospective case review of pediatric patients (<18 years) with orbital floor blowout fractures treated between 2000 and 2013.
• Analysis of patient demographics, fracture characteristics, preoperative motility, and postoperative outcomes, specifically focusing on IR palsy.

Main Results:

• Five out of 48 pediatric patients (10.4%) developed IR palsy.
• Patients with IR palsy were older (mean 16.4 years) and had significantly worse preoperative motility.
• All patients with IR palsy developed postoperative hypertropia (100%) compared to 4.7% without IR palsy.

Conclusions:

• Inferior rectus palsy occurs in 10.4% of pediatric orbital floor blowout fractures.
• Clinical features and outcomes of IR palsy in children may differ from adult populations.
• Age and preoperative motility appear to be significant factors associated with IR palsy in this pediatric cohort.