Pediatric growing orbital roof fracture with ptosis: a case report

The majority of pediatric skull fractures are minimally displaced and can usually be managed conservatively. A rare but serious complication is the development of a growing skull fracture (GSF), that may lead to significant sequelae including orbital meningoencephalocele or neurological impairments. We report a 6-year-old boy who initially presented with right-sided traumatic ptosis and a minimally displaced right orbital roof "blow-up" fracture following minor head trauma. This injury subsequently progressed into a growing orbital roof fracture, complicated by the development of an orbital meningoencephalocele and persistent ptosis seven months post-injury. Our case highlights the importance of early multidisciplinary evaluation and long-term follow-up in pediatric patients with orbital roof fractures, even when initial injuries appear minor. Clinicians should remain vigilant for rare but potentially serious complications, such as growing skull fractures and orbital meningoencephaloceles which can develop months after the initial trauma.