Management of Tripod Fracture in a 4-Year-Old Child

1. Amania Fairuzia
2. Hernawita Suharko

Cipto Mangunkusumo Hospital,Jakarta, Indonesia

Purpose: To report the management of tripod fracture in a 4-year-old child.

Methods: A 4-year-old boy sustained blunt trauma to his right eye after a motor vehicle accident. On examination there was inferior and superior eyelid laceration, enophthalmos, right hypotropia in primary gaze, and limitation of supraduction and infraduction. CT scan examination showed zygomatic-maxillary fracture with soft tissue entrapment. The patient underwent repair of eyelid laceration on the day he was brought to emergency room. Two weeks later he underwent orbital exploration and fracture repair. A comminuted, maxillary fracture was discovered on the medial aspect of right orbital floor with soft tissue entrapment. The tissue was gently released and silicon block was placed on the orbital floor. Zygomatic fracture was also found on the lateral aspect of lateral orbital wall. Fracture repair was then accomplished using wire.

Results: Three months after surgery, enophthalmos was no longer found but still there was slight limitation of supraduction.

Conclusions: A comminuted fracture was less likely to be found in children. Fracture repair using wire did not cause any impairment of orbital development in children.