Influence of age on the management of blow-out fractures of the orbital floor

Man, K. de; Wijngaarde, R.; Hes, J.; Jong, P.T. de

doi:10.1016/s0901-5027(05)80260-7

Cited by 107 publications

(67 citation statements)

References 11 publications

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“…De Man et al [1] reported that 14 of 15 blowout fractures of the inferior orbit in children were trapdoor fractures, and Egbert et al [23] reported that 61.8% of pediatric patients had the trapdoor type. In our hospital, 66 of the 144 cases (45.8%) were of the trapdoor or linear type, which was in contrast to the result of the adult group, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Orbital fractures are common sequelae of blunt trauma to the periocular region and have been occurring more frequently because of the increasing number of traffic accidents, industrial accidents, social activities and violence [1,2]. It can be associated with various ocular and extraocular injuries, and failure of prompt recognition and treatment of these injuries may result in significant cosmetic and functional problems, such as enophthalmos, restriction in ocular motility and ocular dystopia [3].…”

Section: Introductionmentioning

confidence: 99%

“…Numerous studies have been performed on orbital fractures so far [1,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17]. However, much of the literature is either out of date or based on small groups of patients.…”

Section: Introductionmentioning

confidence: 99%

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An Analysis of 733 Surgically Treated Blowout Fractures

Jung

Shin

et al. 2009

Ophthalmologica

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Purpose: To evaluate current patient demographics and surgical outcomes from a large series of 733 surgically treated orbital fractures from an ophthalmologist’s perspective. Methods: We reviewed the medical records of 733 patients with orbital fracture, who were treated surgically by one of the authors at Gil Hospital, Gachon University, from May 2000 until September 2007. Data regarding patient demographics, signs and symptoms at presentation, cause of injury, nature of fracture, associated ocular and nonocular injury, surgical outcome and complications were collected. Results: Male patients outnumbered female patients, and blowout fracture occurred most frequently between the ages of 20 and 29 years (mean age 30.7 years). Violent assault was the leading cause of the fractures, followed by fall/slip and traffic accidents. Common signs and symptoms were periorbital ecchymosis, ocular motility restriction, diplopia and enophthalmos. In the pediatric group, diplopia and ocular motility restriction were the most common. Subconjunctival hemorrhage, hyphema and commotio retinae were the most commonly associated ocular injuries. As for the location of fractures, medial wall fractures were the most common, followed by fractures of the inferior wall, and both medial and inferior walls, in order. The most common type of fracture was the ‘comminuted’ one. In the pediatric group, the percentage of trapdoor-type fracture was higher than in the adult group. Forty-four percent of the patients had diplopia preoperatively and 8.7% postoperatively. The average measurement of difference in the enophthalmos (≧2 mm) patient population was improved from 2.62 (±SD 0.9) to 1.73 (±SD 1.3) after surgery. Ocular motility restriction was preoperatively noted in 297 patients (40.5%), and only 18 patients (2.5%) showed restriction after surgery. Conclusion: Young male individuals are at the highest risk for orbital fractures. There are marked differences in the clinical symptomatology and findings between pediatric and adult orbital fractures. Diplopia, enophthalmos and ocular motility restriction improved by repair of fracture.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An Analysis of 733 Surgically Treated Blowout Fractures

Jung

Shin

et al. 2009

Ophthalmologica

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“…Trapdoor refers to cases in which either edge of the inferior orbital wall is attached to its original position, and nontrapdoor refers to cases in which the inferior orbital wall is completely separated from its original position and the periorbital tissue has escaped into the maxillary sinus (Figure 2). 7 Surgical procedures were performed via transorbital, transantral, or combined approaches. Preoperative and postoperative symptoms were assessed.…”

Section: Methodsmentioning

confidence: 99%

Clinical Analysis of Surgical Approaches for Orbital Floor Fractures

Kwon

Kim

Moon

et al. 2008

Archives of Facial Plastic Surgery

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“…The natural history, clinical symptom, type of fracture, and treatment indication of isolated orbital wall fracture are different in the children from those in the adults (1,2). Children are particularly susceptible to pure orbital fractures of the trapdoor variety (3).…”

Section: Introductionmentioning

confidence: 99%

Orbital Trapdoor Fracture in Children

2003

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This study was performed to evaluate the clinical symptom, fracture finding, and surgical outcome in children with orbital trapdoor fracture. Forty-four patients with pure orbital trapdoor fracture, under 18 yr of age, were included. Time interval between injury and surgery, length of time for improvement, resolution of ocular motility restriction, and other factors were analyzed in 36 patients who underwent surgery. The median improvement time was 3.5 days for patients (n=8) receiving surgery within 5 days, 18.0 for those (n=19) receiving surgery between 6 and 14 days, and 50.0 for those (n=9) receiving surgery after 15 days (p=0.03). One month after operation, the mean change in supraduction limitation was 3.50 +/- 0.53 for patients receiving surgery within 5 days, 2.11 +/- 1.24 for those receiving surgery between 6 and 14 days, and 1.67 +/- 0.82 for those receiving surgery after 15 days (p=0.04). Three months after operation, the mean change in supraduction limitation was 3.88 +/- 0.35, 2.94 +/- 1.55, and 2.50 +/- 1.38, respectively (p=0.14). In conclusion, trapdoor fracture of the orbit in children must be diagnosed by careful CT evaluation and clinical evidence of entrapment. For patients with severe limitation of ocular motility, early surgery within 5 days of injury leads to more rapid and better postoperative improvement.

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Influence of age on the management of blow-out fractures of the orbital floor

Cited by 107 publications

References 11 publications

An Analysis of 733 Surgically Treated Blowout Fractures

An Analysis of 733 Surgically Treated Blowout Fractures

Clinical Analysis of Surgical Approaches for Orbital Floor Fractures

Orbital Trapdoor Fracture in Children

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