![]() The operation was performed when the periorbital swelling disappeared and/or within 2 weeks after the trauma. 2 The state of periorbital swelling after the trauma was recorded. Based on CT, the subjects were divided into groups with trapdoor fractures or open-door fractures ( Figure 1), which was confirmed during the operation. These measurements were compared between the children and adult groups. They were checked for visual acuity and examined with the extraocular muscle movement test, diplopia test, forced duction test, and Hertel exophthalmometry before and after the operation. All patients received an eye examination at the Department of Ophthalmology before and after the operation. The patients were divided into 2 groups: a children group (16 patients aged <16 ) and an adult group (54 patients aged ≥17 ).įor all patients, progress was monitored for at least 3 months, and the average length of observation was 12 months (range, 3-69 months). Our study population comprised 70 patients with blowout fracture of the inferior orbital wall, who were treated surgically from January 1998 to September 2003. After trauma, surgical intervention might be required within 5 days in children with trapdoor fracture vs within 2 weeks in adults. In adults, the recovery period of those who underwent surgery 1 to 5 days and 6 to 14 days after the trauma were significantly shorter compared with those who underwent surgery after 15 days or longer.Ĭonclusions Diplopia, extraocular muscle limitation, and trapdoor fractures were more frequent in children than in adult patients. However, among the 13 children with trapdoor fractures, the recovery period was significantly shorter in those who underwent surgery 1 to 5 days after the trauma compared with those who underwent surgery after 6 to 14 days and 15 days or longer. In the children group, no differences in the recovery period relative to the timing of surgery was noted when all types of orbital fractures were considered. Trapdoor fractures were frequent in the children group (n = 13 81%), whereas 30 patients (56%) had open-door fractures in the adult group. Results Serious periorbital edema was noted in 43 adults (80%) and 4 children (25%), diplopia in 27 adults (50%) and 16 children (100%), and extraocular muscle limitation in 23 adults (43%) and 13 children (81%). Main Outcome Measures Symptoms and fracture patterns were compared between both groups in all subjects, and the recovery period relative to the timing of surgery after the trauma was compared in subjects who complained of diplopia or extraocular limitation. Patients Medical records of 70 patients were reviewed: 16 patients were children (aged <16 years) and 54 were adults (aged ≥17 years). Setting Department of Otorhinolaryngology, Maryknoll General Hospital, Busan, Korea. Objectives To review the clinical features and recovery period of patients with blowout fractures of the inferior orbital wall treated surgically and to examine the differences between children and adults. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.If needed, closed or open reduction methods can be performed with the goal of treatment being preservation of normal facial structure, sensory function, globe position and mastication functionality. On radiographic evaluation, typically with dedicated CT imaging with multiplanar reformats, the following three fracture components are generally identified:įracture of the zygomatic arch and/or diastasis of the temporozygomatic sutureįractures of the inferior orbital rim and anterior and posterior maxillary sinus walls and/or diastasis of the zygomaticomaxillary sutureįracture of the lateral orbital rim and/or diastasis of the frontozygomatic suture Additionally, the fracture components may result in impingement of the temporalis muscle, trismus (limited jaw mobility) and may compromise the infraorbital foramen/ nerve resulting in hypoesthesia (numbness) within its sensory distribution. The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma. They are the second most common facial bone fracture after nasal bone fractures. They can account for ~40% of midface fractures.
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