Is the pure and impure distinction of orbital fractures clinically relevant with respect to ocular and periocular injuries? A retrospective study of 473 patients.

Published on Dec 1, 2019in Journal of Cranio-maxillofacial Surgery1.766
· DOI :10.1016/J.JCMS.2019.10.001
Zulma Catherine3
Estimated H-index: 3
(University of Geneva),
Delphine S. Courvoisier34
Estimated H-index: 34
(University of Geneva),
Paolo Scolozzi15
Estimated H-index: 15
(University of Geneva)
Sources
Abstract
Abstract Objective To determine the association of “pure” orbital fractures (POF) and “impure” orbital fractures (IOF) with ocular and periocular injuries. Materials and methods A retrospective study of patients with orbital fractures was designed. The predictor variable was the orbital's fracture configuration (pure versus impure). The primary outcome variables were ocular and periocular injuries classified as mild, moderate, and severe. The secondary outcome was the need for surgical repair. Standard statistics for patient characteristics, the Fisher exact test for categorical variables, and the Mann–Whitney U test for continuous variables were computed to compare fractures. Results The sample was composed of 473 patients (220 POF and 253 IOF). No significant association between the two groups with regard to ocular and periocular injuries was found. Combined medial wall and floor fractures and naso-orbito-ethmoidal (NOE) fractures had the highest incidence of severe injury (34.5%, p = 0.02). Le Fort fractures were associated with moderate ocular and periocular injuries (36.4%, p = 0.01). Impure orbital fractures were more frequently associated with the need for surgical treatment (p = 0.04) than were POF. Conclusion The present study has demonstrated that the pure and impure distinction of orbital fractures was not clinically relevant with respect to ocular and periocular injuries. However, our findings seem to suggest that other parameters such as the direction of the impact and/or its magnitude, rather than merely the pure or impure configuration, could be involved in determining the risk of developing concomitant ocular and periocular injuries.
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The aim of this study was to determine the predictive value of 4 clinical signs (periorbital ecchymosis, periorbital emphysema, diplopia, and inferior orbital nerve hypoesthesia) for the diagnosis of orbital fractures (OFs) and the need for surgical treatment in patients with orbital trauma. The investigators designed and implemented a retrospective cohort study composed of patients with orbital trauma. The primary and secondary outcomes were respectively the diagnosis of OFs and the need for su...
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#1Sagar Patel (WSU: Wayne State University)H-Index: 5
#2Christopher Andrecovich (WSU: Wayne State University)H-Index: 2
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Importance Orbital floor fractures are commonly seen in clinical practice, yet the etiology underlying the mechanism of fracture is not well understood. Current research focuses on the buckling theory and hydraulic theory, which implicate trauma to the orbital rim and the globe, respectively. Objective To elucidate and define the biomechanical factors involved in an orbital floor fracture. Design, Setting, and Participants A total of 10 orbits from 5 heads (3 male and 2 female) were used for thi...
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Purpose Mid face injuries commonly destroy the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 90.6 % as reported in literature. The eye injuries range from simple subconjunctival haemorrhage to globe rupture. The paper aims to study the types of ocular injuries in patients with ZMC fractures.
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#1Michael W. Ross (McGill University)H-Index: 90
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Abstract Objective To determine the acuity of ophthalmology referral for orbital fractures. Methods This is a retrospective chart review of 73 cases of orbital fractures over a 1-year period at a level I trauma centre. All consultations including those for orbital fractures were included in the study. The age and sex of the patient, date and time of initial emergency room (ER) arrival, date and time of input of the ophthalmology consultation, date and time the patient actually saw ophthalmology,...
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BACKGROUND: Prompt identification of significant ocular injuries in patients who sustain an orbital fracture is important to prevent any potential long-term visual sequelae. The true incidence of these injuries has not been determined, however. As a consequence, most surgeons choose to have all patients evaluated by an ophthalmologist. The objective of this study was to conclusively identify the incidence of significant ocular injuries in patients with isolated orbital fractures and to determine...
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Abstract Objective To investigate diplopia (binocular single vision [BSV] test) and ocular motility (uniocular field of fixation [UFOF] test) characteristics in blow-out fractures of the orbit and their value in fracture management. Material and methods Patients with isolated blow-out fractures treated from 2000 to 2010 were included. BSV scores were stratified into three categories: low BSV category (0–60); moderate BSV category (61–80), and high BSV category (81–100). UFOF scores were also div...
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Abstract The purpose of this study was to retrospectively analyse patients with orbital floor fracture who were treated at the Department of Odontostomatology and Maxillofacial Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy, between 2008 and 2013. Patients were evaluated by age, sex, aetiology, clinical findings, fracture pattern, ocular injury, treatment, complications, and sequelae. We evaluated surgical outcomes and complications with the use of different surgical approach...
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#1Christopher J. Layton (UQ: University of Queensland)H-Index: 11
Purpose. To determine factors associated with the presence of significant ocular injury in subjects with orbital fractures. Subjects. A consecutive prospective cohort of 161 patients presenting to a general tertiary referral hospital with orbital fractures and undergoing initial conservative treatment was identified. Subjects were assessed at time of injury for the need for emergency surgery, and those initially treated conservatively were subsequently followed up by the Ophthalmology Department...
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Objective: To assess the frequency and severity of ophthalmic injuries in patients with orbito-zygomatic fractures. Study Design: A case series.
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ABSTRACT The aim of the present study was to evaluate the injury patterns and etiology of orbital bone fractures treated at a busy level one trauma center.Between 2015 and 2019, patients with orbital bone fractures from the Department of Oral and Maxillofacial Surgery at the Royal London Hospital, were evaluated in a retrospective analysis. A pro-forma was used to collect data from electronic patient records. Parameters included age, gender, maxillofacial fracture, mechanism of injury, and lengt...
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