Clinical characteristics and outcomes of orbital fractures: a sex-based cohort analysis

Purpose: This study aims to identify clinical similarities and differences between males and females presenting with orbital fracture.

Methods: Patient charts of adult orbital fracture cases diagnosed via computed tomography and referred by a level 1 trauma center to the McGill University Health Centre between August 2015 to January 2018 were examined and analyzed. Clinical parameters included age, sex, mechanism of injury, morphology of orbital fracture, symptoms and examination features, and rates of ocular pathology. Comparative analyses were performed via Student's t-test and chi-square to assess for sex-related differences.

Results: The study included 176 males (mean age: 46.2 years) and 68 females (mean age: 58.5 years). The most common etiology of orbital fracture was assault among males (32%) and fall from own or standing height among females (38%). Males had a higher prevalence of bilateral fractures than females (17% vs 6%; p = 0.02) and had more orbital walls fractured per orbit than females (2.0 vs 1.5; p < 0.01). Males were more likely to have their orbital roof fractured (28% vs 15%; p = 0.03) and were more likely to be intubated after their trauma (22% vs 7%; p = 0.004). Post-traumatic ocular pathology occurred in 11% of males versus 9% of females (p = 0.56).

Conclusion: In our cohort of adult orbital fractures, males were more prevalent, more likely to have bilateral fractures, more extensive fracture per orbit, and higher prevalence of orbital roof fractures and intubation. Despite these differences, rates of ocular pathology did not differ significantly between males and females, highlighting the importance of a careful assessment in both groups.