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Type: Journal article
Title: Management of isolated fractures of the medial orbital wall
Author: Snell, B.
Flapper, W.
Moore, M.
Anderson, P.
David, D.
Citation: Journal of Craniofacial Surgery, 2013; 24(1):291-294
Publisher: Lippincott Williams & Wilkins
Issue Date: 2013
ISSN: 1049-2275
Statement of
Broughton J. Snell, Walter Flapper, Mark Moore, Peter Anderson and David J. David
Abstract: The purpose of the present study was to retrospectively review the management and outcome of patients treated by the Australian Craniofacial Unit (ACFU) for isolated fractures of the medial orbital wall. A retrospective medical record review of patients treated between 2008 and 2012 was performed. Ethical approval was granted by the ethics committee of the Women's and Children's Hospital. Patient demographics, causes of injury, physical examination findings, management (conservative or surgical), and findings at follow-up were recorded. Computed tomographic scans were reviewed, and values for fracture area and volume of displaced tissue were calculated. Twenty-four patients with this injury were treated by the ACFU between 2008 and 2012. Eighteen were male, and 6 were female. Assault was the most common cause (15/24 patients). Fifteen patients were managed conservatively, and 9 were treated surgically. In those patients managed conservatively, the mean fracture area was 1.44 cm (0.47-2.47 cm), and the mean volume of displaced tissue was 0.48 mL (0.03-1.15 mL). In patients treated surgically, the mean fracture surface area was 2.32 cm (0.07-3.43 cm), and mean volume of displaced tissue was 0.94 mL (0.00-1.47 mL). No patients were found to have clinically significant enophthalmos at follow-up examination. The current practice of managing isolated fractures of the medial orbital wall at the ACFU has been successful in preventing significant enophthalmos. The thresholds for fracture area and, in particular, volume of displaced tissue, proposed by Jin et al (J Oral Maxillofac Surg 2000;58:617-620), show merit as a tool for determining patient management.
Keywords: Medial orbital wall; enophthalmos; diplopia
Rights: © 2013 Mutaz B. Habal, MD
RMID: 0020124892
DOI: 10.1097/SCS.0b013e3182710490
Appears in Collections:Dentistry publications

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