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Updated: Jun 5, 2025
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Patterns of Orbital Fractures Caused by Sports Injuries in Children
1Resident in Training, Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
Background:
Sports injuries account for 11.3 to 42.1% of the facial fractures. Injuries from contact with a ball, a bat or stick, or another player raise safety concerns.
Purpose:
The purpose of this study was to assess the patterns of sports-related maxillofacial injuries involving orbital bone fractures in children.
Study Design, Setting, And Sample:
This was a retrospective case series of children who presented to Children's Healthcare of Atlanta from 2015 to 2021, with orbital injuries resulting from sports.
Independent Variable:
None.
Outcome Variable:
The outcome variables, including the fracture location, pattern, and the management of injury.
Covariates:
The medical record were reviewed for the following variables: 1) demographic information, 2) mechanism of injury, 3) type of sport, 4) symptoms, 5) length of inpatient stay, and 6) duration of follow-up.
Analysis:
Data were collected using a standardized collection form. Descriptive statistics were calculated.
Results:
Overall, 101 patients (92 males) with an age of 13 ± 3 met the inclusion criteria. The most common sport was baseball or softball (n = 78, 77.2%). The mechanisms of injuries were largely due to collision with the ball (n = 79, 78.2%) or with another player (n = 13, 12.9%). Orbital fractures occurred mostly in the floor (n = 87, 86.1%), followed by the medial wall (n = 22, 21.8%), with an average of 1 surface involved. Maxillary sinus (n = 23, 22.8%) and/or nasal bone (n = 17, 16.8%) were the other facial bones outside of orbit commonly injured. The fractures patterns are minimally/nondisplaced (n = 68, 67.3%), displaced (n = 30, 29.7%), or comminuted (n = 3, 3%). The managements include surgical and nonsurgical. Twenty-three patients (22.8%) underwent surgical intervention. Twelve of them had an emergent operation due to extraocular muscle entrapment.
Conclusion:
Sports injuries are a common cause of orbital trauma in children. Most injuries are due to baseball/softball from collision with the ball. They were mostly managed without surgery, except for the individuals that presented with entrapment, oculocardiac reflex, and a large-size defect. The information from this project could be utilized in implementing safety equipment use for participants to further prevent such injuries.
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