Clinical Features and Radiologic Findings of Orbital Bone Remodeling in Pediatric Patients After Orbital Fracture Correction

The authors analyzed the long-term clinical features and radiologic findings of orbital bone remodeling after the surgical correction of inferior or medial wall blowout fractures (BOFs) in pediatric patients. Patients were included based on the following criteria: age younger than 17 years; surgical BOF correction; and preoperative, postoperative, and follow-up computed tomography scans of the orbit. Bone remodeling was evaluated in 4 categories: bony contour smoothing, bony edge joining, new bone formation, and bone thickening. Logistic regression analysis was used to determine variables associated with successful bone remodeling. Among the 31 patients with BOFs, 19 (61.3%) had inferior wall fractures and 12 (38.7%) had medial wall fractures. Surgical corrections were performed, on average, 13.32 (range, 1-69) days after trauma. The mean age was 11.3 (range, 4-17) years. Linear trapdoor-type fractures were more common in inferior wall fractures ( P =0.009) and in cases of muscle incarceration ( P =0.024), central diplopia ( P =0.003), and restricted eyeball motility ( P =0.012). Most patients (83.9%) had successful bone remodeling, including bony contour smoothing (93.5%), bony edge joining (83.9%), new bone formation (93.5%), and bone thickening (93.5%). In the logistic regression analysis, no variables were significantly associated with bone remodeling. Muscle incarceration was more common in patients with inferior wall fractures, whereas medial wall fractures were associated with a larger fracture size. Most pediatric patients with BOFs experienced successful bone remodeling, regardless of age, fracture type, and size. Surgical correction is recommended for pediatric patients with BOFs to achieve successful bone remodeling.