Fractures about the Orbit in Professional American Football Players

Abstract

A retrospective review was performed of records for players who suffered fractures about the orbit during participation in officially sponsored activities of the National Football League from 1980 to 1997. Clinical information was obtained on 19 of 29 players who sustained orbital fractures. The most common signs and symptoms included decreased visual acuity (74%, 14), decreased eye movement (42%, 8), hyphema (37%, 7), and infraorbital numbness (21%, 4). The mechanisms of injury were a digital poke (74%, 14) and blunt facial trauma (26%, 5). There were significantly more orbital fractures than zygomatic fractures suffered by offensive linemen as compared with all other positions. Fifteen of 19 players were managed with surgical reconstruction; 4 players were treated nonoperatively. The mean time from injury to surgical procedure was 7.7 days (range, 0 to 42). The mean interval to follow-up was 45.6 months (range, 3 to 146). At follow-up examination, eight (53%) of the patients treated surgically still reported diplopia with upper field gaze. Three of the four patients treated nonoperatively were asymptomatic. The mean time lost from games or practice was 25 days (range, 5 to 56). Ultimately, 17 (89%) players with orbital fractures were able to return to full football activities. Two patients were unable to resume their careers because of residual visual impairment.

Adult Maxillofacial Trauma Patterns in American Football

“…Although nasal fractures were the most common overall, mandibular fractures were more likely to occur during football compared to basketball and baseball 32 . Similar patterns were observed in NCAA football participants, 33 although, studies involving players in the NFL demonstrated that most participants sustained midface fractures with no injuries to the upper or lower face 34,35 . In our series of adult patients, nasal bone (53%), midface (25%), and mandible (15%) fractures were prevalent.…”

“…32 Similar patterns were observed in NCAA football participants, 33 although, studies involving players in the NFL demonstrated that most participants sustained midface fractures with no injuries to the upper or lower face. 34,35 In our series of adult patients, nasal bone (53%), midface (25%), and mandible (15%) fractures were prevalent. Furthermore, nasal bone fractures were more common in younger adults, whereas midface fractures were more common in older adults.…”

Types of ocular injury and their antecedent factors: A systematic review and meta‐analysis

“…The 12 studies reported mean CASP grades within the range of 6.50 to 10.0 with a mean score of 7.87 (SD = 1.17). The studies covered the geographic regions of Oceania, Europe, North America, Asia, Africa, and North America (eg, one from Australia, 7 England, 18 Finland, 6 Ghana, 19 India, 8 and eight from the United States 5,11,14,20‐24 ). Six of the studies used secondary data analysis of administrative databases, 6,7,11,18,20,23 two employed a cross‐sectional design, 14,19 two used a prospective design, 8,21 one used a case‐controlled design 24 and one was a retrospective view 5 …”

“…The systematic review identified the following antecedent factors of occupational ocular injury: (a) the use of eye protection at the time of the ocular injury, 6,7,11,18‐20,23 (b) being male, 5‐7,11,14,18‐20,23 (c) exposure to biological or chemical occupational hazards, 7,14,19 (d) mechanical forces, 5,6,8,21 (e) risk‐taking behavior 11,18,19 …”

“…Functional outcomes of ocular injuries result in suffering, barriers to a good quality of life, and reduced workability 3 with a significant amount of lost working days 4 . Work performance is altered by visual acuity, 5 decreased eye movement, 5 poor vision, 6 blindness, 6 permanent burns, 7 posttraumatic stress disorder along with depression, 8 and decreased alertness. The Bureau of Labor Statistics reports that 62% of all lost‐time facial injuries were due to ocular trauma.…”