A Study on Pediatric Linear Orbital Floor Fracture—Surgical Intervention as soon as Possible

Abstract

We encountered four cases of pediatric linear orbital floor fractures with entrapment of the muscle and/or fascial connective tissue. Preoperative CT scan showed the missing rectus sign in two cases, consistent with the intraoperative findings of inferior rectus entrapment. In the other two cases, CT showed an enlarged inferior rectus muscle. All of the patients presented with nausea, vomiting and ocular pain. The surgery had to be delayed in one of the patients with entrapment of the muscle, because of initial treatment at another hospital. This patient who underwent surgery 28 hours after the injury showed persistent upward gaze disturbance for 30 months after the surgery. All the other patients, in whom surgery was carried out as soon as possible, experienced complete recovery. Early operation as soon as possible is recommended for obtaining prompt relief of symptoms and avoidance of permanent sequelae such as upward gaze disturbance.