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Updated: Aug 5, 2025
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Pediatric orbital fractures
Caitlin Coviello1,2, Katherine J Williams2,3, Sunthosh K Sivam1
1Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine.
Insights
Pediatric orbital fractures often benefit from conservative management and close monitoring. For surgical cases, resorbable implants are preferred, with emerging 3D printing techniques showing promise for orbital fracture repair.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Pediatric orbital fractures are rare, presenting unique challenges in evaluation and management.
- Evidence synthesis is crucial for optimizing treatment strategies in this population.
Approach:
- Systematic review of current literature on pediatric orbital fractures.
- Analysis of clinical presentation, diagnostic methods, and management options.
- Evaluation of emerging surgical techniques and reconstructive materials.
Key Points:
- Conservative management with close follow-up is suitable for pediatric orbital fractures without entrapment.
- Resorbable implants are increasingly favored for surgical repair due to minimal impact on craniofacial development.
- Three-dimensional (3D) printing and intraoperative navigation show potential but require further research in pediatric cases.
Conclusions:
- Limited large-cohort studies hinder generalizability, emphasizing the need for more research.
- Treatment decisions for pediatric orbital fractures should consider implant availability, donor site morbidity, and procedural complexity.
- A conservative approach is often effective, reserving surgical intervention for specific indications.
Purpose Of Review:
The aim of this study was to summarize current evidence on the clinical presentation, evaluation, and management of pediatric orbital fractures. Recent trends in management strategies as well as emerging surgical techniques for pediatric orbital fracture repair are presented.
Recent Findings:
Although somewhat limited, growing bodies of evidence support a conservative approach with close follow up in pediatric orbital fractures. For those patients necessitating surgical repair, resorbable implants are increasingly preferred given their lack of donor site morbidity and a minimal impact on the developing craniofacial skeleton. There are emerging data reporting the use of three-dimensional (3D) printing-assisted approaches and intraoperative navigation; however, more research is needed to assess their applicability in the pediatric population.
Summary:
There are few studies with large patient cohorts and long-term follow up given the rare incidence of pediatric orbital fractures, which restricts the generalizability of research on the topic. The studies available increasingly suggest that fractures without clinical evidence of entrapment can be managed conservatively with close follow up. A variety of reconstructive implants are available for those fractures necessitating repair. Donor site morbidity, availability, and need for additional procedures should all be factored into the reconstructive decision-making process.
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