2021
Fraktura orbity v dětském věku
PERCEOVÁ, Klára, Štěpánka BIBROVÁ, Milan URÍK, Ivo ŠLAPÁK, Michal JURAJDA et. al.Základní údaje
Originální název
Fraktura orbity v dětském věku
Název anglicky
Orbital Fractures in Children
Autoři
PERCEOVÁ, Klára (703 Slovensko, domácí), Štěpánka BIBROVÁ (203 Česká republika, domácí), Milan URÍK (703 Slovensko, domácí), Ivo ŠLAPÁK (203 Česká republika, domácí), Michal JURAJDA (203 Česká republika, domácí) a Soňa ŠIKOLOVÁ (203 Česká republika, domácí)
Vydání
Acta Chirurgiae Ortopediae at Traumatologiae Čechoslovaca, Praha, Česká společnost pro ortopedii a traumatologii a Slovenská ortopedická a traumatologická spoločnosť, 2021, 0001-5415
Další údaje
Jazyk
čeština
Typ výsledku
Článek v odborném periodiku
Obor
30211 Orthopaedics
Stát vydavatele
Česká republika
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 0.222
Kód RIV
RIV/00216224:14110/21:00121532
Organizační jednotka
Lékařská fakulta
UT WoS
000652228200004
Klíčová slova anglicky
fracture; orbit; childhood; surgical; non-operative treatment
Příznaky
Recenzováno
Změněno: 7. 6. 2021 13:49, Mgr. Tereza Miškechová
V originále
PURPOSE OF THE STUDY Diagnosis and treatment of fractures of the facial skeleton in children can be difficult due to the skeletal growth. MATERIAL AND METHODS The 9-year retrospective study included patients admitted with the orbital fracture diagnosis to the University Hospital Brno, Children s Hospital, Department of Paediatric ENT, Department of Paediatric Anaesthesiology and Resuscitation, and Department of Paediatric Surgery, Orthopaedics and Traumatology. We looked into the number of patients admitted to the hospital with the orbital fracture diagnosis and the cause of the injury, the age of patients, and the used treatment method - surgical or non-operative treatment were analysed. The following assumptions were applied: 1. Incidence of the injury (orbital fracture) increases with the age of the patient, 2. Incidence of the injury in individual years is constant. RESULTS In the followed-up period, between 2010 and 2018, a total of 47 patients, of whom 8 girls and 39 boys, with the orbital fracture diagnosis were treated. 12 patients underwent surgery, 35 patients were treated non-operatively. The study group included 47 patients with the age range of 1 to 18 years, with the median age 12 years. When the results were processed, a trend was revealed showing an increase in the number of injuries as well as an in the age of patients at the time of injury. The number of injuries increases with age and year. Both the correlations, however, are statistically insignificant and the trend can be considered statistically insignificant. DISCUSSION Both the non-operative and surgical treatment of patients lead to excellent results, even in the long-term follow-up. In paediatric patients, the surgical approach should be opted for only in cases when the non-operative approach is impossible due to the extent and characteristics of fracture and damage to soft tissues. CONCLUSIONS The surgical treatment aims at the best possible anatomical reconstruction of the orbit with no subsequent functional or cosmetic defects. If surgical treatment is necessary, then the transconjunctival approach is most appropriate in children, namely because of the good overview over the operating field, simple procedure as well as the cosmetic outcome. In most cases it is enough to reposition the orbital soft tissues. In complicated cases, with an orbital floor defect, it needs to be covered with a suitable material. Also, the non-operative approach has its place in therapy and the case-by-case approach must be applied. Orbital fractures should always be treated by experienced specialists (ENT, dental surgeon, traumatologist) specialising in paediatric patients.
Anglicky
PURPOSE OF THE STUDY Diagnosis and treatment of fractures of the facial skeleton in children can be difficult due to the skeletal growth. MATERIAL AND METHODS The 9-year retrospective study included patients admitted with the orbital fracture diagnosis to the University Hospital Brno, Children s Hospital, Department of Paediatric ENT, Department of Paediatric Anaesthesiology and Resuscitation, and Department of Paediatric Surgery, Orthopaedics and Traumatology. We looked into the number of patients admitted to the hospital with the orbital fracture diagnosis and the cause of the injury, the age of patients, and the used treatment method - surgical or non-operative treatment were analysed. The following assumptions were applied: 1. Incidence of the injury (orbital fracture) increases with the age of the patient, 2. Incidence of the injury in individual years is constant. RESULTS In the followed-up period, between 2010 and 2018, a total of 47 patients, of whom 8 girls and 39 boys, with the orbital fracture diagnosis were treated. 12 patients underwent surgery, 35 patients were treated non-operatively. The study group included 47 patients with the age range of 1 to 18 years, with the median age 12 years. When the results were processed, a trend was revealed showing an increase in the number of injuries as well as an in the age of patients at the time of injury. The number of injuries increases with age and year. Both the correlations, however, are statistically insignificant and the trend can be considered statistically insignificant. DISCUSSION Both the non-operative and surgical treatment of patients lead to excellent results, even in the long-term follow-up. In paediatric patients, the surgical approach should be opted for only in cases when the non-operative approach is impossible due to the extent and characteristics of fracture and damage to soft tissues. CONCLUSIONS The surgical treatment aims at the best possible anatomical reconstruction of the orbit with no subsequent functional or cosmetic defects. If surgical treatment is necessary, then the transconjunctival approach is most appropriate in children, namely because of the good overview over the operating field, simple procedure as well as the cosmetic outcome. In most cases it is enough to reposition the orbital soft tissues. In complicated cases, with an orbital floor defect, it needs to be covered with a suitable material. Also, the non-operative approach has its place in therapy and the case-by-case approach must be applied. Orbital fractures should always be treated by experienced specialists (ENT, dental surgeon, traumatologist) specialising in paediatric patients.