The Clinical Study of Treatment of Blowout Fracture

ABSTRACT

The orbital blowout fractures has been increasing due to trauma and traffic accidents with time. The diagnostic confirmation is easily established by CT scan, but the indication for surgical treatment, the technique for repair, and timing of repair are still controversial. We have reviewed investigated the charts of 18 cases who had blowout fracture, including the clinical manifestation, surgical indication, surgical procedures, improvement of diplopia, and its complication. The follow up was at least 6 months in the past 5 years. In cases of diplopia only in the upward gaze limitation, or small orbital fracture in orbital CT scan and less degree of enophthalmos, these 8 cases were treated conservatively for 2 weeks and diplopia improved markedly. However, in 10 cases of severe diplopia and in large fracture and tissue incarceration, these were surgically managed using Silastic sheets. In these cases, the diplopia resolved within 1 month in 7 cases(70%). Residual diplopia waS seen in 3 cases, and we retreated surgically for the two cases of them. In the other non surgical cases, diplopia resolved on 6 months follow up except in 2 cases of mild diplopia. Therefore we should pay more attention to surgical indication.