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. 2020 Dec 14;83(3):281-284.
doi: 10.1055/s-0040-1721821. eCollection 2022 Jun.

Pediatric Orbital Roof Fractures: A Ratio of Orbital Dimensions Correlated to Prevalence of Fracture

Stephen C Dryden  1 , Andrew G Meador  1 , Andrew B Johnston  1 , Adrianna E Eder  1 , James C Fleming  2 , Brian Fowler  1
Affiliations

Pediatric Orbital Roof Fractures: A Ratio of Orbital Dimensions Correlated to Prevalence of Fracture

Stephen C Dryden et al. J Neurol Surg B Skull Base. .

Abstract

Objective Orbital roof fractures are more likely to occur in younger children, specifically younger than 7 years. Cranium to face ratio decreases with age; however, there is no definition for measurement of the neurocranium or face. We propose using the length of the orbital roof as a measurement of the neurocranium and length of the orbital floor as a tool to estimate midface size. The purpose of this study is to test this measurement as a correlation rate of orbital roof fractures within the pediatric population. Design This is a retrospective study. Setting This study was done at the LeBonheur Children's Hospital. Participants Sixty-six patients with orbital roof fractures were identified and stratified by gender and age, specifically younger than 7 years and 7 years or older. Main Outcome Measures The main outcome measures were orbital roof length, floor length, and ratio thereof. Results Mean orbital roof length was 43.4 ± 3.06 and 45.1 ± 3.94 mm for patients <7 and ≥7 years, respectively ( p = 0.02). Mean orbital floor length was 41.3 ± 2.99 and 47.7 ± 4.19 for patients <7 and ≥7 years, respectively ( p < 0.00001). The mean roof to floor ratio (RTFR) for patients <7 years was 1.051 ± 0.039 and for patients ≥ 7 years was 0.947 ± 0.031 ( p < 0.00001). Conclusion As children age, the relative length of the orbital roof decreases when compared with the orbital floor. The RTFR was more than 1.0 in children younger than 7 years. These differences were statistically significant when compared with children 7 years and older. This measurement shift follows the differences noted in orbital fracture patterns during childhood.

Keywords: craniofacial; measurement correlate; orbit development; orbital roof fracture; pediatric; pediatric orbital fracture; skull; trauma.

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Conflict of interest statement

Conflict of Interest J.C.F. reports grants from Research to Prevent Blindness, during the conduct of the study; personal fees from AO North America, personal fees from Horizon Pharmaceuticals, outside the submitted work. B.F., A.B.J., A.G.M., A.E.E., and S.C.D. report grants from Research to Prevent Blindness, during the conduct of the study.

Figures

Fig. 1
Fig. 1
Schematic of measurement technique.
See this image and copyright information in PMC

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