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Characterizing Fracture Patterns, Management, and Adverse Outcomes: A Single Institution's Experience of 867 Pediatric Orbital Fractures
Alexander J Comerci, BS
Viraj Govani, BA*
Christopher Fedor, MS*
Tobi Somorin, BS
Zhazira Irgebay, MD
Coleen Lewis, BS
Jesse Goldstein, MD
University of Pittsburgh School of Medicine
2025-01-10
Presenter: Alexander J Comerci
Affidavit:
This project is representative of original work from the entire team
Director Name: Jesse Goldstein
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: The management of orbital fractures in pediatric patients is challenging due to immature facial skeletal development and heightened risks for ophthalmologic sequelae. Although existing literature provides valuable insights, there remains a gap in understanding the epidemiology, patterns, and outcomes, of orbital fractures in large-scale pediatric populations.
Methods: Our retrospective study included patients under 18 at a high-volume pediatric hospital from 2006 to 2021. Study variables included demographics, follow-up, trauma severity, management, and adverse outcomes.
Results: 3,334 patients presented with facial fractures, of which 867 (72% male) presented with orbital fractures. Their average age was 11.0 ± 5.0 years, and they were followed for an average of 17 ± 4.3 days. While adjusting for patient age, sex, and mechanism of injury, patients with level 1 trauma had an 81% increased odds of optic nerve complications (OR: 0.19; 95% CI: 0.05, 0.67; p<0.01) and a 55% increased odds of visual disturbances (OR: 0.45 ; 95% CI: 0.21, 0.95; p<0.04) compared to patients who presented with level 2 trauma. Patients with level 1 trauma had an 82% increased odds of optic nerve complications (OR: 0.18; 95% CI: 0.05, 0.67; p<0.01), and a 60% increased odds of periorbital complications (OR: 0.40 ; 95% CI: 0.25, 0.65; p<0.001) in comparison to those who presented as a level 3 trauma.
Conclusions: This study identifies key factors influencing outcomes in orbital fractures among pediatric patients. Our findings emphasize the need to consider age, gender, and injury severity for better prognosis, management, and long-term outcomes.
