Fractures of the orbital floor

Area of Science:

• Ophthalmology
• Maxillofacial Surgery
• Trauma Surgery

Background:

• Orbital floor fractures are common injuries.
• These fractures can lead to significant morbidity, including diplopia and enophthalmos.
• Understanding treatment outcomes is crucial for patient management.

Purpose of the Study:

• To retrospectively review outcomes of surgical and non-surgical treatments for orbital floor fractures.
• To analyze the incidence of diplopia, enophthalmos, and orbital prolapse.
• To evaluate the effectiveness of different surgical support methods.

Main Methods:

• Retrospective chart review of 324 patients with 363 orbital floor fractures (1965-1973).
• Classification of fractures included isolated floor, rim and floor, trimalar, and complex facial fractures.
• Data collected on initial presentation, treatment modalities (surgical vs. non-surgical), and postoperative outcomes.

Main Results:

• Initial presentation: 31% diplopia, 4% enophthalmos, 31% suspected orbital prolapse, 37% ocular injury.
• Postoperative: 8% diplopia, 7% enophthalmos.
• Long-term follow-up (>5 months): 17% diplopia, 11% enophthalmos.
• Non-surgical group (29 patients): 0% persistent diplopia.

Conclusions:

• Surgical intervention for orbital floor fractures effectively reduces immediate postoperative diplopia and enophthalmos.
• While long-term follow-up shows increased rates, surgical outcomes remain favorable.
• Non-surgical management appears to be a viable option for select orbital floor fractures, avoiding persistent diplopia.