Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants
PurposeThis study aimed to analyze the demographic characteristics, etiology, fracture types, interventions and treatment outcomes, with a focus on the increasing role of bioresorbable implants compared to traditional non-resorbable implants in pediatric orbital fractures.MethodsThis was a retrospec...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-03-01
|
| Series: | Frontiers in Ophthalmology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fopht.2025.1506445/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850227371860295680 |
|---|---|
| author | Emmanuel Lee Boniao Emmanuel Lee Boniao Emmanuel Lee Boniao Emmanuel Lee Boniao Alexander Gungab Alexander Gungab Blanche Xiao Hong Lim Gangadhara Sundar |
| author_facet | Emmanuel Lee Boniao Emmanuel Lee Boniao Emmanuel Lee Boniao Emmanuel Lee Boniao Alexander Gungab Alexander Gungab Blanche Xiao Hong Lim Gangadhara Sundar |
| author_sort | Emmanuel Lee Boniao |
| collection | DOAJ |
| description | PurposeThis study aimed to analyze the demographic characteristics, etiology, fracture types, interventions and treatment outcomes, with a focus on the increasing role of bioresorbable implants compared to traditional non-resorbable implants in pediatric orbital fractures.MethodsThis was a retrospective cohort study conducted at the Department of Ophthalmology, National University Hospital, Singapore, of pediatric patients (aged 18 years or younger) treated surgically for orbital fractures from January 2005 to May 2023. Data was extracted from the hospital’s electronic medical records, including demographic details, causes of fractures, types of fractures, implants used (bioresorbable and non-bioresorbable), and clinical outcomes.Results43 cases of pediatric orbital and orbitofacial fractures met the criteria undergoing surgical intervention. Most occurred in males (81.4%, n=35). Causes of fractures were sports-related incidents and play (46.5%, n=20), assault (30.2%, n=13), road-traffic accidents (16.3%, n=7), and non-play related accidents (7%, n=3). Most pediatric orbital fractures were unilateral (88%, n=38). While most were pure or simple orbital fractures (74.4% n=32), 25.6% (n=11) were complex orbitofacial fractures. Amongst simple orbital fractures, blowout fractures (91%, n=29) were the most common, involving the inferior (58.6%, n=17), combined floor and medial wall (20.6%, n=6), medial wall (13.8%, n=4) and roof (6.9%, n=2). Amongst the complex fractures, zygomaticomaxillary complex fractures were the most frequent (45.4%, n=5), followed by cranioorbital fractures (27.3%, n=3) and Le Fort II & III fractures (27.3%, n=3). Orbital tissue entrapment was common (56%, n=24), and most patients with entrapment underwent urgent surgical intervention (65%, n=28), usually within 24 hours (53%, n=23). The majority of those who underwent surgery had implants placed (89%, n=25), with most being bioresorbable (64.3%, n=18). All patients (100%) who underwent surgery showed clinical improvement without significant complications.ConclusionAlthough simple pediatric orbital blowout fractures are still the most common among pediatric patients, the study showed that a quarter of them presented with complex orbitofacial fractures requiring multidisciplinary management. Most fractures occurred in males and typically associated with increasing play and physical activity in teenagers. The study also showed that early intervention is crucial to better outcome, with the increasing role of bioresorbable implants in this population reducing long term implant related complications. |
| format | Article |
| id | doaj-art-e06383d346a04ecb97f6cb9b6b703bb5 |
| institution | OA Journals |
| issn | 2674-0826 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Ophthalmology |
| spelling | doaj-art-e06383d346a04ecb97f6cb9b6b703bb52025-08-20T02:04:51ZengFrontiers Media S.A.Frontiers in Ophthalmology2674-08262025-03-01510.3389/fopht.2025.15064451506445Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implantsEmmanuel Lee Boniao0Emmanuel Lee Boniao1Emmanuel Lee Boniao2Emmanuel Lee Boniao3Alexander Gungab4Alexander Gungab5Blanche Xiao Hong Lim6Gangadhara Sundar7Orbit & Oculofacial Surgery, Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore, SingaporeDepartment of Ophthalmology, Amai Pakpak Medical Center, Marawi, PhilippinesDepartment of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro, PhilippinesDepartment of Ophthalmology, Western Visayas Medical Center, Iloilo, PhilippinesOrbit & Oculofacial Surgery, Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore, SingaporeDepartment of Ophthalmology, Fatima University Medical Center, Antipolo, PhilippinesOrbit & Oculofacial Surgery, Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore, SingaporeOrbit & Oculofacial Surgery, Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore, SingaporePurposeThis study aimed to analyze the demographic characteristics, etiology, fracture types, interventions and treatment outcomes, with a focus on the increasing role of bioresorbable implants compared to traditional non-resorbable implants in pediatric orbital fractures.MethodsThis was a retrospective cohort study conducted at the Department of Ophthalmology, National University Hospital, Singapore, of pediatric patients (aged 18 years or younger) treated surgically for orbital fractures from January 2005 to May 2023. Data was extracted from the hospital’s electronic medical records, including demographic details, causes of fractures, types of fractures, implants used (bioresorbable and non-bioresorbable), and clinical outcomes.Results43 cases of pediatric orbital and orbitofacial fractures met the criteria undergoing surgical intervention. Most occurred in males (81.4%, n=35). Causes of fractures were sports-related incidents and play (46.5%, n=20), assault (30.2%, n=13), road-traffic accidents (16.3%, n=7), and non-play related accidents (7%, n=3). Most pediatric orbital fractures were unilateral (88%, n=38). While most were pure or simple orbital fractures (74.4% n=32), 25.6% (n=11) were complex orbitofacial fractures. Amongst simple orbital fractures, blowout fractures (91%, n=29) were the most common, involving the inferior (58.6%, n=17), combined floor and medial wall (20.6%, n=6), medial wall (13.8%, n=4) and roof (6.9%, n=2). Amongst the complex fractures, zygomaticomaxillary complex fractures were the most frequent (45.4%, n=5), followed by cranioorbital fractures (27.3%, n=3) and Le Fort II & III fractures (27.3%, n=3). Orbital tissue entrapment was common (56%, n=24), and most patients with entrapment underwent urgent surgical intervention (65%, n=28), usually within 24 hours (53%, n=23). The majority of those who underwent surgery had implants placed (89%, n=25), with most being bioresorbable (64.3%, n=18). All patients (100%) who underwent surgery showed clinical improvement without significant complications.ConclusionAlthough simple pediatric orbital blowout fractures are still the most common among pediatric patients, the study showed that a quarter of them presented with complex orbitofacial fractures requiring multidisciplinary management. Most fractures occurred in males and typically associated with increasing play and physical activity in teenagers. The study also showed that early intervention is crucial to better outcome, with the increasing role of bioresorbable implants in this population reducing long term implant related complications.https://www.frontiersin.org/articles/10.3389/fopht.2025.1506445/fullorbital fracturesorbitofacial fracturespediatric orbital fractureswhite-eye blow out fracturesentrapmentorbital implants |
| spellingShingle | Emmanuel Lee Boniao Emmanuel Lee Boniao Emmanuel Lee Boniao Emmanuel Lee Boniao Alexander Gungab Alexander Gungab Blanche Xiao Hong Lim Gangadhara Sundar Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants Frontiers in Ophthalmology orbital fractures orbitofacial fractures pediatric orbital fractures white-eye blow out fractures entrapment orbital implants |
| title | Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants |
| title_full | Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants |
| title_fullStr | Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants |
| title_full_unstemmed | Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants |
| title_short | Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants |
| title_sort | pediatric orbital fractures in singapore demographics etiology and the role of bioresorbable implants |
| topic | orbital fractures orbitofacial fractures pediatric orbital fractures white-eye blow out fractures entrapment orbital implants |
| url | https://www.frontiersin.org/articles/10.3389/fopht.2025.1506445/full |
| work_keys_str_mv | AT emmanuelleeboniao pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT emmanuelleeboniao pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT emmanuelleeboniao pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT emmanuelleeboniao pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT alexandergungab pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT alexandergungab pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT blanchexiaohonglim pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants AT gangadharasundar pediatricorbitalfracturesinsingaporedemographicsetiologyandtheroleofbioresorbableimplants |