A study on the clinical improvement according to the fracture sites pure blow-out fracture

ABSTRACT

As the traffic accidents and occupational accidents increase, the pure blow out fracture has been increased. If we could know the prognostic information of the pure blowout fracture according to the fracture sites, it would be of benefit in consulting the patients preoperatively and in planning the treatment. In this study we defined the posterior wall fracture as that extending 2 cm from orbital rim and the anterior wall fracture as that presenting within 2 cm from orbital rim. These fractures were individually classified into inferior wall fractures, medial wall fractures, and combined inferior and medial wall fractures, based on the operative finding and the preoperative CT scanning. We experienced 76 cases of pure blowout fracture patients underwent surgical correction and followed up the subsidence of diplopia and extraocular muscle limitation with ophthalmic Hess test. The results obtained are as following 1. Posterior wall fractures were improved more slowly than anterior wall fractures. 2. Combined inferior and medial wall fractures were improved more slowly than isolate inferior wall or medial wall fractures. These results may be related to the difference of the traumatic forces and the anatomical structure of the fracture sites. These results inform the importance of accurate anatomical reconstruction of fracture sites and can be used as a prognostic information of the pure blow out fractures.