title: Patterns and injuries associated with orbital wall fractures in elderly patients who visited the emergency room: a retrospective case-control study.
abstract: This study aimed to determine orbital wall fracture (OWF) patterns and associated facial injuries in elderly patients and compare them with those in their younger adult counterparts.
  
  
  
  A retrospective case-control study.
  
  
  
  An emergency department of a university-affiliated hospital located in an urban area.
  
  
  
  A total of 1378 adult patients with OWF diagnosed by CT from 1 January 2004 through 31 March 2014 were enrolled. Patients were categorised into elderly (≥65 years) and non-elderly (<65 years) groups.
  
  
  
  The elderly group (n=146) had a mean age of 74.0 years compared with 37.5 years in the non-elderly group (n=1232). Slipping was the most common cause of OWF in the elderly group (43.8%, p<0.001), whereas violence was the most common cause in the non-elderly group (37.3%, p<0.001). The lateral orbital wall was the more common site of fracture in the elderly group, and their injuries were more often associated with concurrent facial bone fractures, including the mandible, maxilla and zygoma, compared with the non-elderly group. After adjusting for sex and the mechanism of injury, inclusion in the elderly group was a significant risk factor for fracture of the lateral wall (OR 1.658; 95% CI 1.074 to 2.560) and concomitant facial bone fractures of the maxilla (OR 1.625; 95% CI 1.111 to 2.377) and zygoma (OR 1.670; 95% CI 1.126 to 2.475).
  
  
  
  Elderly patients were vulnerable to facial trauma, and concurrent facial bone fracture associated with OWF was more commonly observed in this age group. Therefore, a high index of suspicion and thorough investigation, including CT, for OWF-associated facial bone fractures are important.
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Youn-Jung
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dong-Woo
authors.initials: DW
authors.lastname: Seo
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hyung-Joo
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: In-June
authors.initials: IJ
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Yang
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Seung Mok
authors.initials: SM
authors.lastname: Ryoo
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lim
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004636:Emergency Service, Hospital; D005151:Facial Injuries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009917:Orbital Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014505:Urban Population
keywords: Orbital fracture; aging; emergency service; facial injuries; geriatric