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Published on: August 14, 2018
Pediatric Nasoorbitoethmoid Fractures: Cause, Classification, and Management
Joseph Lopez1, J D Luck1, Muhammad Faateh1
1From the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; Rush Medical College of Rush University; the Division of Plastic Surgery, University of Washington Medical Center; the R Adams Cowley Shock Trauma Center, University of Maryland Medical Center; the Department of Biostatistics, Boston University School of Public Health; and the Division of Pediatric Plastic Surgery, University Hospital Rainbow Babies and Children's Hospital.
Pediatric nasoorbitoethmoid fractures are rare. Transnasal wiring effectively prevents telecanthus in type III fractures, while type I fractures may be observed, and type II/III warrant operative intervention.
Area of Science:
- Pediatric Traumatology
- Craniofacial Surgery
- Ophthalmology
Background:
- Nasoorbitoethmoid fractures in children are infrequently documented.
- Information on their presentation and management is limited.
- This study addresses the paucity of data on pediatric nasoorbitoethmoid fractures.
Purpose of the Study:
- To investigate the incidence, etiology, and associated injuries of pediatric nasoorbitoethmoid fractures.
- To analyze the management strategies for these fractures.
- To evaluate outcomes of transnasal wiring versus suture canthopexy for type III nasoorbitoethmoid fractures.
Main Methods:
- Retrospective cohort review of pediatric nasoorbitoethmoid fractures (1990-2010).
- Classification using the Markowitz-Manson system.
- Analysis of fracture patterns, demographics, and outcomes via univariate and multivariate methods.
Main Results:
- 63 pediatric patients identified; mean age 8.78 years.
- 18 type I, 28 type II, 17 type III fractures.
- Operative intervention rates: 16.7% (type I), 46.4% (type II), 82.4% (type III).
- Transnasal wiring prevented telecanthus in type III fractures.
Conclusions:
- Pediatric nasoorbitoethmoid fractures are uncommon.
- Type I fractures may be managed non-operatively; type II and III require surgical consideration.
- Transnasal wiring is effective for preventing telecanthus in type III nasoorbitoethmoid fractures.
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