{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:31:53Z","timestamp":1789723913201,"version":"4.0.1"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Data regarding clinical predictors of orbital fractures in children are limited. We sought to describe the epidemiology of pediatric orbital fractures and identify the signs and symptoms of orbital fractures in children.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We performed a retrospective cohort study of children younger than 22 years who underwent a facial or orbital computed tomography (CT) scan to evaluate for orbital fracture. We included patients presenting to an emergency department of a tertiary care children's hospital between January 2009 and May 2013. The presence of an orbital fracture was assessed using the final interpretation of the CT by an attending radiologist in the electronic medical record.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 326 children who underwent facial or orbital CT during the study period, 133 (41%) had an orbital fracture. The presence of nausea or vomiting, orbital tenderness, swelling, or ecchymosis and limitation of extraocular movement were each associated with the presence of an orbital fracture (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05 for each). Twenty-two children (6.7% of cohort and 16.5% of children with orbital fractures) underwent surgical repair for an orbital fracture. In the absence of orbital tenderness, swelling, or ecchymosis, there was 1 child with an orbital fracture who underwent operative intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Fewer than half of children undergoing CT have an orbital fracture identified, and fewer than 7% have a fracture that requires operative intervention. In the absence of orbital tenderness, swelling, or ecchymosis, only 1 child had an orbital fracture requiring surgical repair.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001306","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T17:13:42Z","timestamp":1508260422000},"page":"21-24","source":"Crossref","is-referenced-by-count":19,"title":["Epidemiology and Predictors of Orbital Fractures in Children"],"prefix":"10.1097","volume":"34","author":[{"given":"Andrew F.","family":"Miller","sequence":"first","affiliation":[{"name":"From the *Division of Emergency Medicine, Boston Children's Hospital; and \u2020Harvard Medical School, Boston, MA; and \u2021Section of Emergency Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Elman","sequence":"additional","affiliation":[{"name":"From the *Division of Emergency Medicine, Boston Children's Hospital; and \u2020Harvard Medical School, Boston, MA; and \u2021Section of Emergency Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Aronson","sequence":"additional","affiliation":[{"name":"From the *Division of Emergency Medicine, Boston Children's Hospital; and \u2020Harvard Medical School, Boston, MA; and \u2021Section of Emergency Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir A.","family":"Kimia","sequence":"additional","affiliation":[{"name":"From the *Division of Emergency Medicine, Boston Children's Hospital; and \u2020Harvard Medical School, Boston, MA; and \u2021Section of Emergency Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I.","family":"Neuman","sequence":"additional","affiliation":[{"name":"From the *Division of Emergency Medicine, Boston Children's Hospital; and \u2020Harvard Medical School, Boston, MA; and \u2021Section of Emergency Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20231023","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/00004397-200110000-00010","article-title":"Developments in the understanding and management of pediatric orbital fractures","volume":"41","year":"2001","journal-title":"Int Ophthalmol Clin"},{"key":"bib2-20231023","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1001\/archotol.1990.01870010045014","article-title":"Pediatric maxillofacial trauma. Age-related variations in injury","volume":"116","year":"1990","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"bib3-20231023","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1001\/archotol.1995.01890120033006","article-title":"Orbital fractures in children","volume":"121","year":"1995","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"bib4-20231023","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1055\/s-0032-1332213","article-title":"Pediatric orbital fractures","volume":"6","year":"2013","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"bib5-20231023","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s12663-012-0402-6","article-title":"Maxillofacial injuries in children: a 10 year retrospective study","volume":"12","year":"2013","journal-title":"J Maxillofac Oral Surg"},{"key":"bib6-20231023","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/ICU.0b013e3282ba54ac","article-title":"Systematic approach to pediatric ocular trauma","volume":"18","year":"2007","journal-title":"Curr Opin Ophthalmol"},{"key":"bib7-20231023","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.tripleo.2011.01.035","article-title":"Retrospective analysis of 314 orbital fractures","volume":"113","year":"2012","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"bib8-20231023","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1097\/SCS.0b013e3181acde01","article-title":"Analysis of orbital bone fractures: a 12-year study of 391 patients","volume":"20","year":"2009","journal-title":"J Craniofac Surg"},{"key":"bib9-20231023","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/IOP.0b013e318295f91d","article-title":"Orbital fractures: national inpatient trends and complications","volume":"29","year":"2013","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"bib10-20231023","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/01676830701519374","article-title":"Evaluation and management of pediatric orbital fractures in a primary care setting","volume":"26","year":"2007","journal-title":"Orbit"},{"key":"bib11-20231023","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0161-6420(00)00015-4","article-title":"Internal orbital fractures in the pediatric age group: characterization and management","volume":"107","year":"2000","journal-title":"Ophthalmology"},{"key":"bib12-20231023","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/RCT.0b013e318169bfdc","article-title":"Facial fractures in children: unique patterns of injury observed by computed tomography","volume":"33","year":"2009","journal-title":"J Comput Assist Tomogr"},{"key":"bib13-20231023","first-page":"313","article-title":"Orbital blow-out fractures in children: characterization and surgical outcome","volume":"33","year":"2010","journal-title":"Chang Gung Med J"},{"key":"bib14-20231023","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3341\/kjo.2003.17.1.44","article-title":"Clinical analysis of internal orbital fractures in children","volume":"17","year":"2003","journal-title":"Korean J Ophthalmol"},{"key":"bib15-20231023","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0194-59980300487-X","article-title":"Pediatric orbital floor fractures: nausea\/vomiting as signs of entrapment","volume":"129","year":"2003","journal-title":"Otolaryngol Neck Surg"},{"key":"bib16-20231023","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1542\/peds.112.4.951","article-title":"Computed tomography and radiation risks: what pediatric health care providers should know","volume":"112","year":"2003","journal-title":"Pediatrics"},{"key":"bib17-20231023","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1055\/s-0029-1224775","article-title":"Medial wall fracture: an update","volume":"2","year":"2009","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"bib18-20231023","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.bjoms.2013.05.009","article-title":"Orbital fractures in children: a review of outcomes","volume":"51","year":"2013","journal-title":"Br J Oral Maxillofac Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201801000-00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T02:12:06Z","timestamp":1698027126000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201801000-00005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001306","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2018,1]]}}}