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[Severed musculus rectus internus caused by a dog bite].

P D Reese1, G F Judisch

  • 1Tufts-New England Medical Center, Dept. of Ophthalmology, Boston.

Klinische Monatsblatter Fur Augenheilkunde
|November 1, 1988
PubMed
Summary

A dog bite severed a child's medial rectus muscle, despite imaging suggesting it was intact. Surgical exploration revealed the complete severance of the muscle parenchyma.

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Area of Science:

  • Ophthalmology
  • Trauma Surgery

Background:

  • Facial injuries from animal bites, particularly dog bites, can pose significant risks to ocular structures.
  • Accurate assessment of extraocular muscle integrity is crucial for managing orbital trauma.

Observation:

  • A four-year-old female patient presented with facial trauma secondary to multiple dog bites.
  • Initial computed tomography (CT) scans suggested the medial rectus muscle was intact, despite observed adduction saccades.

Findings:

  • Surgical exploration of the orbit revealed complete severance of the medial rectus muscle parenchyma.
  • This finding contrasts with the preoperative imaging results, highlighting potential limitations of CT in detecting subtle muscle injuries.

Implications:

  • This case underscores the importance of thorough surgical exploration in orbital trauma, even when imaging appears non-conclusive.
  • It emphasizes the potential for severe, intra-muscular injuries that may not be fully visualized by standard radiological techniques.
  • Prompt and accurate diagnosis and surgical management are vital for preserving visual function and ocular motility after severe facial trauma.

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