| PurposeWith the increase of stress in our life and the number of traffic accidents.the incidence of orbital blowout fracture is obviously rising.The development of image technology and the further grasp of operation time and the development of repair materials make the orbital blowout fracture has better prospects in treatment and prognosis, but patients with enophthalmos and diplopia are still the main factors of life and work.This study retrospectively analyzed287cases of patients with the pure orbital blowout fracture, discussing the relationship of incidence rate and degree of enophthalmos with different fracture type;the relationship of the age of patients with different fracture type;the relationship of the changes of extraocular muscle forms with different fracture types;the relationship of different extraocular muscle morphological changes and injured time’s with diplopia type, and compared that whether enophthalmos and double vision and the age were different with the different fracture,to choose more suitable treatment method for patients and reduce the occurrence of complications,finally avoiding unnecessary damage.MethodsRretrospectively analyzed287cases of patients with the pure orbital blowout fracture from January1995to September2012, filter condition was through history and imaging diagnosis for pure single orbital blowout fracture, not accompanied by nasal bone or maxillary fracture. Collected the clinical data including age,injuried time,signs and symptoms, etc.According to the different parts were divided into medial wall, inferior wall and the both. Due to the lateral wall and the superior wall is rare, so no researched in this paper. The medial wall and inferior wall fracture type was mainly divided into comminuted fracture,collapse type fracture, open window fracture and linear fracture. Due to the joint fracture was more complex, it was roughly divided into the medial was main fracture, the inferior was main fracture and the same range fracture. According to the size of the possibility cause diplopia and extraocular muscles morphological changes after injuried,extraocular muscles changes roughly were divided into five types,including incarcerated,adhesion, contorts, enlargement and no change. Using SPSS statistics software to carry on the corresponding statistics, discussing the relationship of incidence rate and degree of enophthalmos with different fracture type and part;the relationship of the age of patients with different fracture type and part;the relationship of the changes of extraocular muscle with different fracture types; The relationship of the time of injury with forced ductions test.Results1.Enophthalmos and diplopia in orbital blowout fracture is a common complication, accompanied by varying degrees of extraocular muscle morphological change. Enophthalmos associated with fracture type and double vision associated with the change of extraocular muscle morphology.2.Comminuted fracture and collapse type were more occurred enophthalmos in the medial wall and the inferior wall,as well as the degree of enophthalmos, which were statistically significant and had the different characteristics, P<0.05. Linear fracture often happened at teenage children and crushing and collapse often occured in adults, which were statistically significant and had the different characteristics, P<0.05.3.The joint fracture in the three types of fractures had no obvious difference in occurrence rate of enophthalmos, P>0.05.On the occurrence degree of enophthalmos followed by the medial and inferior wall with same fracture range, the inferior was main fracture and the medial was main fracture, which were statistically significant and had the different characteristics, P<0.05.4.The four fracture types of medial wall and inferior wall could occured different forms of extraocular muscle change, but linear fractures tended to occur embedded and rarely had the change of contorts. crushing, collapse and open window type rarely occured embedded,contorts and abnormal enlargement occured more, Incarcerated occurred in injured at the time, had nothing to do with the time to morning and evening,there was a relation that limited of other three different forms of extraocular muscle changes after forced ductions test with the time when see a doctor,which were statistically significant and had the different characteristics, P<0.05.5.The joint fracture occurred extraocular muscle morphological change was complicated, overall extraocular muscle incarcerated rarely happened,but more occurred comprehensive changes such as adhesion,contorts and the abnormal enlargement,except incarcerated there was a relation that limited of other different forms of extraocular muscle changes after forced ductions test with the time when see a doctor,which were statistically significant and had the different characteristics, P<0.05.6.Compared the three parts of orbital blowout fracture,the joint fracture occurred rate and degree of enophthalmos that were greater than the simple medial wall fracture and the simple inferior wall fracture, which were statistically significant and had the different characteristics,P<0.05.On age the simple medial wall fracture and the simple inferior wall fracture were under the age of the joint fracture, which were statistically significant and had the different characteristics, P<0.05.On double vision compared the three parts of orbital blowout fracture,the most happened was the inferior wall fracture,following the joint fracture and the medial wall fracture, which were statistically significant and had the different characteristics, P<0.05.ConclusionsBy analyzing the different degree of enophthalmos caused by different fracture parts and types and the different diplopia types caused by extraocular muscle morphological changes and different treatment time, they have a certain preliminary guidance significance to clinical, forced ductions test not only have a certain clinical significance in diagnosis of orbital blowout fracture,it is also an effective method in improving diplopia,it could reduce secondary surgical trauma. |
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