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. 2018 Mar;11(1):28-34.
doi: 10.1055/s-0037-1601884. Epub 2017 May 2.

Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Stephanie M Young  1 , Yan Tong Koh  2 , Errol W Chan  1 , Shantha Amrith  1
Affiliations

Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Stephanie M Young et al. Craniomaxillofac Trauma Reconstr. 2018 Mar.

Abstract

The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16.4 ± 1.5 years) compared with patients without IR palsy (12.4 ±3.3 years), had significantly ( p < 0.05) worse preoperative motility, and had significantly greater proportion developing postoperative hypertropia (100%) compared with patients without IR palsy (4.7%). Our series of pediatric blowout fractures demonstrated IR palsy prevalence and clinical features for IR palsy which may be distinct to the pediatric group.

Keywords: inferior rectus palsy; orbital fracture; pediatric blowout fractures; trauma.

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Conflict of interest statement

Conflict of Interest and Source of Funding The authors declare no conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Figures

Fig. 1
Fig. 1
Fracture extent assessed and classified into three groups—A1: floor lateral to infraorbital canal; A2: floor medial to infraorbital canal; A3: involving the inferomedial strut. The fracture site is represented by the blue arrows.
Fig. 2
Fig. 2
Fracture quantification: measurements were made from the medial anatomical landmark (orbital strut between medial wall and floor) to the medial (X) and lateral (Y) border of the fracture in each CT slice. The arrows represent the normal anatomical landmarks of the medial and lateral borders of the orbital floor.
Fig. 3
Fig. 3
Two-dimensional diagram of orbital fracture measurement in a sample patient.
Fig. 4
Fig. 4
Patients with and without inferior rectus (IR) palsy, each group having fracture type A1, A2, and A3.
See this image and copyright information in PMC

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