{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:54:44Z","timestamp":1788875684095,"version":"build-2803163510"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Orbital trapdoor fracture occurs more commonly in pediatric patients, and previous studies suggested early intervention for a better outcome. However, there is no consensus on the appropriate timing of emergent intervention due to the insufficient cases reported. In the current retrospective study, we compared the outcomes of patient groups with different time intervals from injury to surgical intervention and entrapment content. Twenty-three patients who underwent surgery for trapdoor fracture between January 2001 and September 2018 at Chang Gung Memorial Hospital were enrolled. There was no significant difference in diplopia and extraocular muscle (EOM) movement recovery rate in patients who underwent surgery within three days and those over three days. However, among the patients with an interval to surgery of over three days, those with muscle entrapment required a longer period of time to recover from EOM movement restriction (p = 0.03) and diplopia (p = 0.03) than those with soft tissue entrapment. Regardless of time interval to surgery, patients with muscle entrapment took longer time to recover from EOM movement restriction (p = 0.036) and diplopia (p = 0.042) and had the trend of a worse EOM recovery rate compared to patients with soft tissue entrapment. Hence, we suggested that orbital trapdoor fractures with rectus muscle entrapment should be promptly managed for faster recovery.<\/jats:p>","DOI":"10.3390\/children9030398","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T12:58:36Z","timestamp":1647003516000},"page":"398","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Outcome Analysis of Surgical Timing in Pediatric Orbital Trapdoor Fracture with Different Entrapment Contents: A Retrospective Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4197-4181","authenticated-orcid":false,"given":"Pei-Ju","family":"Hsieh","sequence":"first","affiliation":[{"name":"Division of Traumatic Plastic Surgery, Department of Plastic and Reconstructive Surgery, Craniofacial Research Center, Chang Gung Memorial Hospital at LinKou, Chang Gung University College of Medicine, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9259-9839","authenticated-orcid":false,"given":"Han-Tsung","family":"Liao","sequence":"additional","affiliation":[{"name":"Division of Traumatic Plastic Surgery, Department of Plastic and Reconstructive Surgery, Craniofacial Research Center, Chang Gung Memorial Hospital at LinKou, Chang Gung University College of Medicine, Taoyuan City 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan"},{"name":"Department of Plastic Surgery, Xiamen Chang Gung Hospital, Xiamen 361000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/SCS.0b013e3181c466e2","article-title":"Endoscope-Assisted Repair of Pediatric Trapdoor Fractures of the Orbital Floor: Characterization and Management","volume":"21","author":"Kim","year":"2010","journal-title":"J. Craniofacial Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.joms.2009.12.037","article-title":"Surgical Management of Orbital Trapdoor Fracture in a Pediatric Population","volume":"68","author":"Gerbino","year":"2010","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1097\/00006534-199903000-00004","article-title":"Mechanisms of Extraocular Muscle Injury in Orbital Fractures","volume":"103","author":"Iliff","year":"1999","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00006534-198408000-00004","article-title":"Volkmann\u2019s Contracture of the Extraocular Muscles Following Blowout Fracture","volume":"74","author":"Smith","year":"1984","journal-title":"Plast. Reconstr. 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Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"881","DOI":"10.3346\/jkms.2003.18.6.881","article-title":"Orbital Trapdoor Fracture in Children","volume":"18","author":"Yoon","year":"2003","journal-title":"J. Korean Med. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1136\/bjophthalmol-2018-311954","article-title":"Delayed Surgical Treatment of Orbital Trapdoor Fracture in Paediatric Patients","volume":"103","author":"Su","year":"2019","journal-title":"Br. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jcms.2015.01.010","article-title":"Surgical Outcomes of Orbital Trapdoor Fracture in Children and Adolescents","volume":"43","author":"Yang","year":"2015","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jaapos.2006.08.022","article-title":"Linear Nondisplaced Orbital Fractures with Muscle Entrapment","volume":"11","author":"Criden","year":"2007","journal-title":"J. Am. Assoc. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/00002341-199811000-00001","article-title":"Intervention within Days for Some Orbital Floor Fractures: The White-Eyed Blowout","volume":"14","author":"Jordan","year":"1998","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.injury.2017.04.039","article-title":"Prospective Study on Ocular Motility Limitation Due to Orbital Muscle Entrapment or Impingement Associated with Orbital Wall Fracture","volume":"48","author":"Alinasab","year":"2017","journal-title":"Injury"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1016\/j.ophtha.2008.02.025","article-title":"Underestimation of Soft Tissue Entrapment by Computed Tomography in Orbital Floor Fractures in the Pediatric Population","volume":"115","author":"Parbhu","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_15","first-page":"955","article-title":"Oculocardiac Reflex Caused by Orbital Floor Trapdoor Fracture: An Indication for Urgent Repair","volume":"116","author":"Sires","year":"1998","journal-title":"Arch. 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Emerg. Med."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/3\/398\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:34:55Z","timestamp":1760135695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/3\/398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,11]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["children9030398"],"URL":"https:\/\/doi.org\/10.3390\/children9030398","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,11]]}}}