FP53

Tackling pediatric orbital floor fracture - "When less is more"

Aim-To compare functional outcome between non surgical and surgical management of orbital floor fractures in pediatric age group and to propose a management protocol in pediatric orbital floor fractures(POFF) based on clinical features at presentation. Method-44 children presenting with POFF were classified radiologically as trapdoor fracture, fracture with incarceration and depressed fracture. Results-33 children(75%) were managed conservatively and 11(25%) underwent surgical exploration via transconjunctival approach. Of 11 managed surgically, 5 were white eyed blow out fracture(WEBOF) requiring immediate surgery. Of 33 children managed conservatively, 31(91.3%)recovered motility restriction, 2 had persistent diplopia in upgaze, but it was inconsequential. Conclusion- POFF behaves differently in view of distinct healing response with most cases showing gratifying response to conservative management. Gross movements restriction, persistent diplopia, muscle entrapment warrants surgery.