Pediatric orbital floor fracture: Direct extraocular muscle involvement
To study the clinical presentation, operative findings, and postoperative results of a surgical series of isolated orbital floor fractures in children. Noncomparative, retrospective, consecutive case series. Thirty-four patients (34 orbits) less than 18 years of age with isolated orbital floor fract...
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| Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 2000-10, Vol.107 (10), p.1875-1879 |
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| creator | Egbert, James E May, Kevin Kersten, Robert C Kulwin, Dwight R |
| description | To study the clinical presentation, operative findings, and postoperative results of a surgical series of isolated orbital floor fractures in children.
Noncomparative, retrospective, consecutive case series.
Thirty-four patients (34 orbits) less than 18 years of age with isolated orbital floor fractures. Indications for surgery were severe limitation of extraocular ductions, 22 of 34; enophthalmos, 8 of 34: or both, 4 of 34.
Surgical repair.
Cause of fracture, symptoms, clinical signs, radiographic data, operative findings, postoperative results, and complications.
Children older than 12 years of age were more likely to sustain an orbital floor fracture as a result of interpersonal violence than were children less than 12 years of age (
P = 0.020). Sixty-two percent of patients (21 of 34) exhibited pain with eye movements and/or nausea and vomiting. Most had a trapdoor type fracture (21 of 34). The inferior rectus muscle was entrapped in the orbital floor fracture in 69% (18 of 26) of patients with a severe limitation of ocular ductions. Preoperative nausea and vomiting were immediately relieved after surgery. The median time for improvement of preoperative duction deficits and diplopia was 4 days for patients receiving surgery within 7 days and 10.5 days for those undergoing surgery after 14 days (
P = 0.030). Resolution of duction deficits or diplopia was not dependent on time of surgery if performed within 1 month of injury. Loss of vision, worsening of motility, or implant complications did not occur.
Pediatric patients with isolated orbital floor fractures who had pain, nausea, vomiting, and severe limitation of extraocular motility often have direct entrapment of the inferior rectus muscle into the fracture site. Surgical repair rapidly relieved preoperative pain, nausea, and vomiting. For patients with severe limitation of ductions, early surgical repair within 7 days of injury resulted in more rapid improvement of ductions and diplopia than surgery performed later. |
| doi_str_mv | 10.1016/S0161-6420(00)00334-1 |
| format | Article |
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Noncomparative, retrospective, consecutive case series.
Thirty-four patients (34 orbits) less than 18 years of age with isolated orbital floor fractures. Indications for surgery were severe limitation of extraocular ductions, 22 of 34; enophthalmos, 8 of 34: or both, 4 of 34.
Surgical repair.
Cause of fracture, symptoms, clinical signs, radiographic data, operative findings, postoperative results, and complications.
Children older than 12 years of age were more likely to sustain an orbital floor fracture as a result of interpersonal violence than were children less than 12 years of age (
P = 0.020). Sixty-two percent of patients (21 of 34) exhibited pain with eye movements and/or nausea and vomiting. Most had a trapdoor type fracture (21 of 34). The inferior rectus muscle was entrapped in the orbital floor fracture in 69% (18 of 26) of patients with a severe limitation of ocular ductions. Preoperative nausea and vomiting were immediately relieved after surgery. The median time for improvement of preoperative duction deficits and diplopia was 4 days for patients receiving surgery within 7 days and 10.5 days for those undergoing surgery after 14 days (
P = 0.030). Resolution of duction deficits or diplopia was not dependent on time of surgery if performed within 1 month of injury. Loss of vision, worsening of motility, or implant complications did not occur.
Pediatric patients with isolated orbital floor fractures who had pain, nausea, vomiting, and severe limitation of extraocular motility often have direct entrapment of the inferior rectus muscle into the fracture site. Surgical repair rapidly relieved preoperative pain, nausea, and vomiting. For patients with severe limitation of ductions, early surgical repair within 7 days of injury resulted in more rapid improvement of ductions and diplopia than surgery performed later.</description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/S0161-6420(00)00334-1</identifier><identifier>PMID: 11013191</identifier><identifier>CODEN: OPHTDG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Accidental Falls ; Accidents, Traffic ; Adolescent ; Athletic Injuries - complications ; Biological and medical sciences ; Child ; Child, Preschool ; Eye Injuries - diagnostic imaging ; Eye Injuries - etiology ; Eye Injuries - surgery ; Female ; Humans ; Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents ; Male ; Medical sciences ; Nausea - diagnosis ; Nausea - etiology ; Ocular Motility Disorders - diagnostic imaging ; Ocular Motility Disorders - etiology ; Ocular Motility Disorders - surgery ; Oculomotor Muscles - diagnostic imaging ; Oculomotor Muscles - injuries ; Orbit - diagnostic imaging ; Orbit - injuries ; Orbital Fractures - diagnostic imaging ; Orbital Fractures - etiology ; Orbital Fractures - surgery ; Pain - diagnosis ; Pain - etiology ; Retrospective Studies ; Tomography, X-Ray Computed ; Traumas. Diseases due to physical agents ; Violence ; Vomiting - diagnosis ; Vomiting - etiology</subject><ispartof>Ophthalmology (Rochester, Minn.), 2000-10, Vol.107 (10), p.1875-1879</ispartof><rights>2000 American Academy of Ophthalmology, Inc.</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c343t-86de126fe6ab6a47907d8677d5ea41f5bb630b2e83104c4cd8c6c41f27514d7a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0161642000003341$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=816494$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11013191$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egbert, James E</creatorcontrib><creatorcontrib>May, Kevin</creatorcontrib><creatorcontrib>Kersten, Robert C</creatorcontrib><creatorcontrib>Kulwin, Dwight R</creatorcontrib><title>Pediatric orbital floor fracture: Direct extraocular muscle involvement</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>To study the clinical presentation, operative findings, and postoperative results of a surgical series of isolated orbital floor fractures in children.
Noncomparative, retrospective, consecutive case series.
Thirty-four patients (34 orbits) less than 18 years of age with isolated orbital floor fractures. Indications for surgery were severe limitation of extraocular ductions, 22 of 34; enophthalmos, 8 of 34: or both, 4 of 34.
Surgical repair.
Cause of fracture, symptoms, clinical signs, radiographic data, operative findings, postoperative results, and complications.
Children older than 12 years of age were more likely to sustain an orbital floor fracture as a result of interpersonal violence than were children less than 12 years of age (
P = 0.020). Sixty-two percent of patients (21 of 34) exhibited pain with eye movements and/or nausea and vomiting. Most had a trapdoor type fracture (21 of 34). The inferior rectus muscle was entrapped in the orbital floor fracture in 69% (18 of 26) of patients with a severe limitation of ocular ductions. Preoperative nausea and vomiting were immediately relieved after surgery. The median time for improvement of preoperative duction deficits and diplopia was 4 days for patients receiving surgery within 7 days and 10.5 days for those undergoing surgery after 14 days (
P = 0.030). Resolution of duction deficits or diplopia was not dependent on time of surgery if performed within 1 month of injury. Loss of vision, worsening of motility, or implant complications did not occur.
Pediatric patients with isolated orbital floor fractures who had pain, nausea, vomiting, and severe limitation of extraocular motility often have direct entrapment of the inferior rectus muscle into the fracture site. Surgical repair rapidly relieved preoperative pain, nausea, and vomiting. For patients with severe limitation of ductions, early surgical repair within 7 days of injury resulted in more rapid improvement of ductions and diplopia than surgery performed later.</description><subject>Accidental Falls</subject><subject>Accidents, Traffic</subject><subject>Adolescent</subject><subject>Athletic Injuries - complications</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Eye Injuries - diagnostic imaging</subject><subject>Eye Injuries - etiology</subject><subject>Eye Injuries - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nausea - diagnosis</subject><subject>Nausea - etiology</subject><subject>Ocular Motility Disorders - diagnostic imaging</subject><subject>Ocular Motility Disorders - etiology</subject><subject>Ocular Motility Disorders - surgery</subject><subject>Oculomotor Muscles - diagnostic imaging</subject><subject>Oculomotor Muscles - injuries</subject><subject>Orbit - diagnostic imaging</subject><subject>Orbit - injuries</subject><subject>Orbital Fractures - diagnostic imaging</subject><subject>Orbital Fractures - etiology</subject><subject>Orbital Fractures - surgery</subject><subject>Pain - diagnosis</subject><subject>Pain - etiology</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Violence</subject><subject>Vomiting - diagnosis</subject><subject>Vomiting - etiology</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kVFL3UAQhRep6K31JyiBgrQPsTPZzW7ii5TbehUEC9XnZbOZwMom0d3kov--G70VhpmH-ThwzmHsBOEcAeWPv2lhLkUB3wC-A3AuctxjKyxFnQuF_BNbfSCH7HOMjwAgJRcH7BCTBMcaV2zzh1pnpuBsNobGTcZnnR_HkHXB2GkOdJH9coHslNHLFMxoZ29C1s_ResrcsB39lnoapi9svzM-0vHuHrGHq9_36-v89m5zs_55m1su-JRXsiUsZEfSNNIIVYNqK6lUW5IR2JVNIzk0BVUcQVhh28pKmx6FKlG0yvAjdvau-xTG55nipHsXLXlvBhrnqFXBAWpVJvB0B85NT61-Cq434VX_t56ArzvARGt88jtYFz-4CqWoRaIu3ylKpraOgo7W0WBTaksquh2dRtBLJfqtEr3krWGZVIlG_g9GunyL</recordid><startdate>20001001</startdate><enddate>20001001</enddate><creator>Egbert, James E</creator><creator>May, Kevin</creator><creator>Kersten, Robert C</creator><creator>Kulwin, Dwight R</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20001001</creationdate><title>Pediatric orbital floor fracture: Direct extraocular muscle involvement</title><author>Egbert, James E ; May, Kevin ; Kersten, Robert C ; Kulwin, Dwight R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-86de126fe6ab6a47907d8677d5ea41f5bb630b2e83104c4cd8c6c41f27514d7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Accidental Falls</topic><topic>Accidents, Traffic</topic><topic>Adolescent</topic><topic>Athletic Injuries - complications</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Eye Injuries - diagnostic imaging</topic><topic>Eye Injuries - etiology</topic><topic>Eye Injuries - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nausea - diagnosis</topic><topic>Nausea - etiology</topic><topic>Ocular Motility Disorders - diagnostic imaging</topic><topic>Ocular Motility Disorders - etiology</topic><topic>Ocular Motility Disorders - surgery</topic><topic>Oculomotor Muscles - diagnostic imaging</topic><topic>Oculomotor Muscles - injuries</topic><topic>Orbit - diagnostic imaging</topic><topic>Orbit - injuries</topic><topic>Orbital Fractures - diagnostic imaging</topic><topic>Orbital Fractures - etiology</topic><topic>Orbital Fractures - surgery</topic><topic>Pain - diagnosis</topic><topic>Pain - etiology</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Violence</topic><topic>Vomiting - diagnosis</topic><topic>Vomiting - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egbert, James E</creatorcontrib><creatorcontrib>May, Kevin</creatorcontrib><creatorcontrib>Kersten, Robert C</creatorcontrib><creatorcontrib>Kulwin, Dwight R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egbert, James E</au><au>May, Kevin</au><au>Kersten, Robert C</au><au>Kulwin, Dwight R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric orbital floor fracture: Direct extraocular muscle involvement</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>2000-10-01</date><risdate>2000</risdate><volume>107</volume><issue>10</issue><spage>1875</spage><epage>1879</epage><pages>1875-1879</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><coden>OPHTDG</coden><abstract>To study the clinical presentation, operative findings, and postoperative results of a surgical series of isolated orbital floor fractures in children.
Noncomparative, retrospective, consecutive case series.
Thirty-four patients (34 orbits) less than 18 years of age with isolated orbital floor fractures. Indications for surgery were severe limitation of extraocular ductions, 22 of 34; enophthalmos, 8 of 34: or both, 4 of 34.
Surgical repair.
Cause of fracture, symptoms, clinical signs, radiographic data, operative findings, postoperative results, and complications.
Children older than 12 years of age were more likely to sustain an orbital floor fracture as a result of interpersonal violence than were children less than 12 years of age (
P = 0.020). Sixty-two percent of patients (21 of 34) exhibited pain with eye movements and/or nausea and vomiting. Most had a trapdoor type fracture (21 of 34). The inferior rectus muscle was entrapped in the orbital floor fracture in 69% (18 of 26) of patients with a severe limitation of ocular ductions. Preoperative nausea and vomiting were immediately relieved after surgery. The median time for improvement of preoperative duction deficits and diplopia was 4 days for patients receiving surgery within 7 days and 10.5 days for those undergoing surgery after 14 days (
P = 0.030). Resolution of duction deficits or diplopia was not dependent on time of surgery if performed within 1 month of injury. Loss of vision, worsening of motility, or implant complications did not occur.
Pediatric patients with isolated orbital floor fractures who had pain, nausea, vomiting, and severe limitation of extraocular motility often have direct entrapment of the inferior rectus muscle into the fracture site. Surgical repair rapidly relieved preoperative pain, nausea, and vomiting. For patients with severe limitation of ductions, early surgical repair within 7 days of injury resulted in more rapid improvement of ductions and diplopia than surgery performed later.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11013191</pmid><doi>10.1016/S0161-6420(00)00334-1</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Ophthalmology (Rochester, Minn.), 2000-10, Vol.107 (10), p.1875-1879 |
| issn | 0161-6420 1549-4713 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Accidental Falls Accidents, Traffic Adolescent Athletic Injuries - complications Biological and medical sciences Child Child, Preschool Eye Injuries - diagnostic imaging Eye Injuries - etiology Eye Injuries - surgery Female Humans Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents Male Medical sciences Nausea - diagnosis Nausea - etiology Ocular Motility Disorders - diagnostic imaging Ocular Motility Disorders - etiology Ocular Motility Disorders - surgery Oculomotor Muscles - diagnostic imaging Oculomotor Muscles - injuries Orbit - diagnostic imaging Orbit - injuries Orbital Fractures - diagnostic imaging Orbital Fractures - etiology Orbital Fractures - surgery Pain - diagnosis Pain - etiology Retrospective Studies Tomography, X-Ray Computed Traumas. Diseases due to physical agents Violence Vomiting - diagnosis Vomiting - etiology |
| title | Pediatric orbital floor fracture: Direct extraocular muscle involvement |
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