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A consecutive case review of orbital blowout fractures and recommendations for comprehensive management.

Abstract：

BACKGROUND:The orbital blowout fracture is a common facial injury, but full consensus has not been reached regarding its optimal management. The authors retrospectively explored consecutive cases of blowout fractures and proposed new recommendations for treatment. METHODS:Two hundred eight newly registered patients were selected from the database of Nagasaki University Hospital over the past 5 years. One hundred nine patients in the authors' department were then reviewed regarding computed tomographic classification of fracture types, preoperative complaints, and outcomes. RESULTS:Of the 208 patients reviewed, 43 underwent surgical repair: 37 for diplopia and 14 for enophthalmos, including eight patients who were treated for both conditions. Regarding floor fractures, the punched-out type fracture was the most common, but the burst type was associated with the highest likelihood of undergoing surgery. For medial wall fractures, the punched-out type dominated, but the overall operative incidence was lower than that observed for the floor fractures. For diplopia, more than half of the operations were performed within 2 weeks, but only two cases were performed within 3 days. For enophthalmos, over 60 percent of operations were carried out after 1 month. Two cases, later discovered to involve muscle strangulation, continued to demonstrate residual diplopia in ordinary use, and two patients continued to show enophthalmos. However, overall outcomes were considered satisfactory. CONCLUSIONS:If computed tomographic findings disclose a linear fracture with muscular strangulation, urgent surgery must be performed. However, for linear fractures without impaction of the muscle, or punched-out or burst type fractures, close observation for days may be appropriate. In addition, surgical intervention can be performed electively when diplopia persists for several days of observation.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Yano H,Nakano M,Anraku K,Suzuki Y,Ishida H,Murakami R,Hirano A

doi

10.1097/PRS.0b013e3181addbbd

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

602-611

issue

eissn

0032-1052

issn

1529-4242

pii

00006534-200908000-00036

journal_volume

124

pub_type

杂志文章

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A consecutive case review of orbital blowout fractures and recommendations for comprehensive management.