Please cite this article in press as: Sirichai P, Anderson PJ. Orbital fractures in children: 10 years’ experience from a tertiary centre. Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.06.007 ARTICLE IN PRESS YBJOM-4546; No. of Pages 5 British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx Available online at www.sciencedirect.com Orbital fractures in children: 10 years’ experience from a tertiary centre Peranada Sirichai a,* , Peter J. Anderson a,b,c,d a Adelaide Dental School, University of Adelaide, Adelaide, South Australia 5005, Australia b Australian Craniofacial Unit, Women’s and Children’s Hospital, Adelaide, South Australia 5006, Australia c Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia 5005, Australia d Department of Oral & Maxillofacial Surgery, Universiti Sains Malaysia, Kota Bharu, Malaysia Accepted 4 June 2015 Abstract Our aim was to examine the relations between type and site of the fracture, age of the patient, and the management and outcomes, among children diagnosed with orbital fractures at the Women’s and Children’s Hospital, Adelaide, during a 10-year period from 1 January 2003 to 31 December 2012. The records of 41 children whose ages ranged from 8 months to 15 years were analysed. There was a male predominance (n=33). Two most common fractures were orbital floor and multiwalled fractures, with medial wall as the second most common site. The most common cause of injury was sport, more often with increasing age. In contrast, falls were more common among young children. Fractures of the orbital roof were more common among young children, all of ours being in children 10 years old or less. Lateral wall fractures were also more common among young children and declined in frequency with increasing age. In contrast, fractures of the orbital floor and medial wall can occur at any age, though those of the medial wall were more common among older children. As children grow their behaviour and activities change, and the mechanism by which they become injured also changes. Growth and development of the craniofacial skeleton lead to differences in the patterns of fractures with age. Fractures of the orbital roof and lateral wall are more common among young children, while those of the orbital floor and medial wall can occur at any age. © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Keywords: Orbit; Children; Fractures Introduction Fractures of the facial skeleton in children are uncommon, 1 and disruption of the complex facial anatomy can affect essential functions including vision, speech, breathing, and mastication, as well as taste, hearing, and smell. Life- threatening injuries to the brain and spinal cord can occur in association with facial fractures. Clinically facial fractures in children are important because they can result in local disturbance of growth. * Corresponding author at: Adelaide Dental Hospital, Frome Road, Ade- laide, South Australia 5001, Australia. Fax: +61 8 81617080. E-mail address: pearlsirichai@yahoo.com (P. Sirichai). Orbital fractures in children are relatively uncommon compared with adults, and the pattern is known to differ from the adult pattern. 2 The differences can be attributed to anatomical differences between the immature and the fully-developed craniofacial skeleton, as the orbits, situated between the cranium and the facial skeleton, change through- out development. At birth a large cranium sits on top of a relatively small face, with a cranium: face ratio of 8:1. 3 The cranium completes its growth early, while the face contin- ues to develop and eventually attains a cranium:face ratio of 2.5:1 in adulthood, 4 and this difference is responsible for the changes in the orbital anatomy. Pneumatisation of the paranasal sinuses throughout childhood also changes how the force of trauma is distributed on impact. 3,5 http://dx.doi.org/10.1016/j.bjoms.2015.06.007 0266-4356/© 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.