期刊文献+

眼眶外侧壁击人性骨折的临床特征及手术治疗 被引量:1

Clinical features and treatment of lateral orbital wall blow-in fracture
原文传递
导出
摘要 目的探讨眼眶外侧壁击人性骨折的临床特征及手术治疗要点。方法回顾性系列病例研究。分析2007年1月至2010年1月在上海交通大学医学院附属第九人民医院眼科住院诊治的12例眼眶外侧壁击人性骨折患者的临床资料,结合术后复查结果,分析此类型骨折的临床特点及治疗预后。结果12例眼眶外侧壁击人性骨折病例均表现为颧骨额突楔人眶内,其中1例眼球破裂行一期眼球摘除手术,4例发生外伤性视神经病变。1例表现为眼球突出,8例眼球内陷。复视5例,眼球运动障碍5例。眼部合并损伤有:上睑畸形3例,上睑下垂1例,内眦间距增宽合并泪道损伤3例。合并骨折有:眶底骨折11例,颧弓骨折9例,眶内壁骨折6例,鼻眶筛骨折3例。手术治疗根据损伤范围采用下睑缘髓毛下切口、口内切口、冠状切口、眉下外侧眶缘切口或原有伤口,完全复位骨折片,钛钉钛板固定,多孔聚乙烯或钛网修复合并的眶内壁或底壁骨折,伤后骨折已畸形愈合的病例,采用截骨复位术修复骨折。11例行眶壁整复手术的病例,眶壁骨折均得到准确复位。结论眼眶外侧壁击人性骨折对眼部损伤严重,应提高对此类骨折的认识,及时采取有效的治疗。 Objective To analyze the clinical features of lateral orbital wall blow-in fracture and summarize the points of treatment. Methods A retrospective analysis of 12 patients with lateral orbital wall blow-in fracture treated in the Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine from January 2007 to January 2010 was investigated. Clinical records and results of follow-up were analyzed. Results Twelve cases of the lateral orbital wall blow-in fracture with the frontal process of the zygoma impacted into the orbit were confirmed. Globe rupture occurred in 1 case, 4 cases had traumatic optic neuropathy. 1 case suffered exophthalmos, 8 cases had enophthalmos. Diplopia was found in 5 cases and eyeball movement disturbance in 5 cases. 3 cases had upper eyelid deformity, 1 case had ptosis, 3 cases had telecanthus accompanied with lacrimal ducts obstruction, 11 cases suffered orbital floor fracture, 9 cases had zygomatic arc fracture, 6 cases had orbital medial wall fracture, and 3 cases had naso-orbito-ethmoid fracture. Surgical treatment was performed by different combination of approaches according to the extents of injury; Osteotomy was performed in patients whose blow-in fracture was malformation. Orbital reconstructive surgery was performed in 11 patients and fractures were completely restored. Conclusions The lateral orbital wall blow-in fracture could cause serious impairment to the ocular components, better outcomes could be achieved by timely and proper treatment with improving recognition of this type of fracture.
出处 《中华眼科杂志》 CAS CSCD 北大核心 2011年第9期806-810,共5页 Chinese Journal of Ophthalmology
基金 基金项目:上海市重点学科(S30205) 国家自然科学基金(30973279,81000404) 上海交通大学医工合作项目(YG2009ZD102)
关键词 眶骨折 眼外科手术 Orbital fractures Ophthalmologic surgical procedures
  • 引文网络
  • 相关文献

参考文献16

  • 1Dingman RO, Natvig P. Surgery of facial fractures. Philadelphia: Saunders, 1964:234.
  • 2Godoy J, Mathog RH. Malar fractures associated with exophthalmos. Arch Otolaryngol, 1985,111 : 174-177.
  • 3Gruss JS, Hurwitz JJ. Isolated blow-ln fracture of the lateral orbit causing globe rupture. Ophthal Plast Reconstr Surg, 1990,6:221- 224.
  • 4Funk GF, Stanley RB Jr, Becker TS. Reversible visual loss due to impacted lateral orbital wall fractures. Head Neck, 1989,11 : 295- 300.
  • 5Stanley RB Jr, Sires BS, Funk GF, et al. Management of displaced lateral orbital wall fractures associated with visual and ocular motility disturbances. Plast Reconstr Surg, 1998,102:972-979.
  • 6Koo L, Hatton MP, Rubin PA. Traumatic blindness after a displaced lateral orbital wall fracture. J Trauma, 2007,62:1288- 1289.
  • 7Eski M, Sahin I, Deveci M, et al. A retrospective analysis of 101 zygomatico-orbital fractures. J Craniofac Surg, 2006, 17 : 1059- 1064.
  • 8Obuekwe O, Owotade F, Osaiyuwu O. Etiology and pattern of zygomatic complex fractures: a retrospective study. J Natl Med Assoc, 2005,97 : 992 -996.
  • 9Hollier LH, Thornton J, Pazmino P, et al. The management of orbitozygomatic fractures. Plast Reconstr Surg, 2003,111 : 2386- 2392, quiz 2393.
  • 10Cahan MA, Fischer B, Iliff NT, et al. Less common orbital fracture patterns: the role of computed tomography in the management of depression of the inferior oblique origin and lateral rectus involvement in blow-in fractures. J Craniofac Surg, 1996,7: 449-459.

同被引文献5

引证文献1

;
使用帮助 返回顶部