Patterns of Orbital Fractures Caused by Sports Injuries in Children.

Background: Sports injuries account for 11.3 to 42.1% of the facial fractures. Injuries from contact with a ball, a bat or stick, or another player raise safety concerns.

Purpose: The purpose of this study was to assess the patterns of sports-related maxillofacial injuries involving orbital bone fractures in children.

Study design, setting, and sample: This was a retrospective case series of children who presented to Children's Healthcare of Atlanta from 2015 to 2021, with orbital injuries resulting from sports.

Independent variable: None.

Outcome variable: The outcome variables, including the fracture location, pattern, and the management of injury.

Covariates: The medical record were reviewed for the following variables: 1) demographic information, 2) mechanism of injury, 3) type of sport, 4) symptoms, 5) length of inpatient stay, and 6) duration of follow-up.

Analysis: Data were collected using a standardized collection form. Descriptive statistics were calculated.

Results: Overall, 101 patients (92 males) with an age of 13 ± 3 met the inclusion criteria. The most common sport was baseball or softball (n = 78, 77.2%). The mechanisms of injuries were largely due to collision with the ball (n = 79, 78.2%) or with another player (n = 13, 12.9%). Orbital fractures occurred mostly in the floor (n = 87, 86.1%), followed by the medial wall (n = 22, 21.8%), with an average of 1 surface involved. Maxillary sinus (n = 23, 22.8%) and/or nasal bone (n = 17, 16.8%) were the other facial bones outside of orbit commonly injured. The fractures patterns are minimally/nondisplaced (n = 68, 67.3%), displaced (n = 30, 29.7%), or comminuted (n = 3, 3%). The managements include surgical and nonsurgical. Twenty-three patients (22.8%) underwent surgical intervention. Twelve of them had an emergent operation due to extraocular muscle entrapment.

Conclusion: Sports injuries are a common cause of orbital trauma in children. Most injuries are due to baseball/softball from collision with the ball. They were mostly managed without surgery, except for the individuals that presented with entrapment, oculocardiac reflex, and a large-size defect. The information from this project could be utilized in implementing safety equipment use for participants to further prevent such injuries.