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Unilateral orbital floor fractures.

M Andersen, P Vibe, I M Nielsen

    Scandinavian Journal of Plastic and Reconstructive Surgery
    |January 1, 1985
    PubMed
    Summary
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    This study on orbital floor fractures found that timely surgery within seven days of injury minimizes complications. Autogenous bone grafts were used for fractures requiring transplantation, with long-term follow-up assessing outcomes.

    Area of Science:

    • Ophthalmology
    • Maxillofacial Surgery
    • Trauma Surgery

    Background:

    • Orbital floor fractures are common facial injuries.
    • Accurate diagnosis and timely surgical intervention are crucial for optimal outcomes.

    Purpose of the Study:

    • To evaluate the operative findings, surgical indications, and long-term outcomes of patients with suspected unilateral orbital floor fractures.
    • To assess the accuracy of preoperative imaging techniques (X-ray and tomography) in diagnosing orbital fractures.
    • To determine the impact of surgical timing on postoperative complications.

    Main Methods:

    • Retrospective analysis of 90 patients undergoing surgery for suspected orbital floor fractures.
    • Evaluation of patient demographics, etiology, operative findings, and surgical techniques.

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  • Postoperative assessment using questionnaires at three months and one to 11 years, focusing on diplopia, enophthalmos, hypesthesia, reduced mobility, and sinusitis.
  • Analysis of preoperative X-ray and tomographic findings versus operative results.

    • Main Results:

    • Of 90 patients, 56 had fractures requiring transplantation, 24 had fractures not requiring it, and 10 had no fractures.
    • Autogenous bone graft was the sole method of transplantation.
    • Long-term follow-up revealed postoperative complications including diplopia (8/82), enophthalmos (2/82), hypesthesia (18/82), reduced mobility (4/82), and sinusitis (4/82).
    • Preoperative imaging showed discrepancies, with false positives and negatives in both X-ray and tomography.
    • Surgery within seven days of injury showed no significant difference in complication rates compared to later surgery, though later surgery was associated with increased chronic sinusitis.

    Conclusions:

    • Autogenous bone grafting is effective for orbital floor reconstruction.
    • Preoperative imaging can be unreliable in diagnosing orbital fractures.
    • Timely surgical intervention within seven days of injury is recommended to minimize complications, particularly chronic sinusitis.