Spontaneous Recovery Of A Fronto-orbital Blow-in Fracture In A Child
Wang, Y., Zhou, H., Xiao, C., Bi, X., Ji, Y., & Fan, X. (2011). spontaneous recovery of a fronto-orbital blow-in fracture in a child. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 69(6), 1736–1739. https://doi.org/10.1016/j.joms.2010.07.051
View Original Source →Case Details
Disease Location
Left periorbital hematoma, left patientosis
Personal Characteristics
4.5-year old male in motorcycle crash
Clinical Characteristics
CT scan showed fractured left supraorbital rim with displaced fragments into the orbital cavity that impinged on the left globe, linear fracture of the left orbital roof and frontal fracture with obvious disrupatiention of depressed frontal bone compressing the brain
Remission Characteristics
Family refused medical treatment; 6.5 months later, no patientosis, no globe displacement, no eye movement disorders, no diplopia; CT scan showed left supraorbital rim and frontal fracture had spontaneously reduced without displaced fragments
Treatment & Mechanisms
Proposed Remission Mechanisms
Force of increased orbital tension due to blowout fracture may have acted to constantly resist the displaced fragments until the tension was relieved; when tension decreased, the rebalanced orbital tension would have been the major force to spontaneously reduce the supraorbital rim blow-in fracture; normal growth of the bony orbit and orbital contents might have contributed to restore blow-in fracture; several forces may have combined to restore depressed fragments to their normal position, including 1) rebounding force of the dura mater and brain, 2) pulsation of the brain and cerebral fluid, 3) normal development of brain, dura mater, and frontal bone; high flexibility of the facial and skull bones in children caused by low ossification provides the depressed and blow-in fragments another intrinsic force to rebound back to their original position; the thick and less readily torn periosteum also increases reduction force on the fragments
Clinical Treatment
Intravenous injection of antibiotics at first hospital after injury
Non-Clinical Treatment
None reported discussed