Does diplopia persist after blow-out fractures of the orbital floor in children?

Blow-out fractures of the orbital floor are comparatively rare in children, particularly those less than 8 years old, Published reports have suggested that the long-term outcome in children is worse than that in adults with s imilar injuries. In this study, we examine this question in the light of da ta from 45 children from Birmingham and Glasgow who were divided into three age ranges: 0-9 years (n = 9), 10-12 years (n = 11) and 13-15 years (n = 2 5), Fourteen were treated conservatively and 31 were treated surgically. Th e 0-9-year-old group were more likely to have small- or medium-sized defect s in the anterior part of the orbital floor, which were of a linear 'trapdo or' type. The 13-15-year-olds tended to have larger 'open-door' defects. Mo re than half the 0-9-year-olds had persistent diplopia compared with just u nder a third of the two other age groups. This diplopia took twice as long to resolve in the younger group compared with the other two groups. Our res ults confirm the view that younger patients have more persistent problems t han adults after blow-out fractures of the orbital floor.