Ahmad F, Kirkpatrick W N A, Lyne J, Urdang M, Garey L J, Waterhouse N
Imperial College School of Medicine, London, UK.
Br J Plast Surg. 2003 Jan;56(1):3-9. doi: 10.1016/s0007-1226(02)00467-8.
Since the first description of orbital blow-out fractures, there has been much confusion as to their aetiology. Two principal mechanisms have been proposed to explain these fractures, the buckling and hydraulic mechanisms, caused by trauma to the orbital rim and the globe of the eye, respectively. Previous experimental and clinical studies have aimed to support one or other of these two theories. However, these studies have failed to provide quantifiable data to objectively support their conclusions. We present the results of a study of these two proposed mechanisms under identical conditions, using quantifiable intraocular pressure, variable and quantifiable force, and quantifiable bone strain distribution with strain gauge analysis in fresh intact human post-mortem cadavers. Both qualitative and quantitative findings suggest that efforts to establish one theory over the other as the primary mechanism have been misplaced. Both mechanisms produce orbital floor fractures, although these fractures differ fundamentally in their size and location. We have objectively demonstrated that it is easier to fracture the orbital floor by the hydraulic mechanism than by the buckling mechanism, and provided quantitative data for the average force required to displace the orbital floor.
自首次描述眼眶爆裂性骨折以来，其病因一直存在诸多争议。目前已提出两种主要机制来解释这些骨折，即分别由眼眶边缘和眼球受到创伤引起的屈曲机制和液压机制。以往的实验和临床研究旨在支持这两种理论中的一种。然而，这些研究未能提供可量化的数据来客观支持其结论。我们在相同条件下对这两种提出的机制进行了研究，使用可量化的眼内压、可变且可量化的力，并通过应变片分析对新鲜完整的人类尸体进行可量化的骨应变分布研究。定性和定量研究结果均表明，将一种理论确立为主要机制而否定另一种理论的做法是错误的。两种机制都会导致眶底骨折，尽管这些骨折在大小和位置上有根本差异。我们已客观证明，通过液压机制导致眶底骨折比屈曲机制更容易，并提供了使眶底移位所需平均力的定量数据。
