MORTON W R, TURNBULL W
Can Med Assoc J. 1964 Jan 11;90(2):58-61.
Blowout fractures of the orbit, a frequent complication of midfacial trauma, result from an increased intraorbital pressure which "blows out" the weakest area-the floor. Intraorbital fat and muscles herniated into the maxillary sinus, muscles incarcerated in the fracture, and the displaced orbital contents produce diplopia. After incarceration, elevation of the affected eye is impossible.Diagnosis is frequently difficult because initial intraorbital hemorrhage may limit mobility. Tomograms in the Waters' projection may show the fracture but frequently reveal only a cloudy antrum. The muscle traction test described herein is most helpful.The surgical correction aims at bridging the defect with Teflon or stainless-steel mesh or endogenous bone graft placed beneath the periosteum. Entry is gained through the lower lid. If repaired early, there is no functional loss and the repair is cosmetically excellent.
眼眶爆裂性骨折是面中部创伤的常见并发症,是由于眶内压力增加致使最薄弱区域——眶底“爆裂”所致。眶内脂肪和肌肉疝入上颌窦,肌肉嵌顿于骨折处,以及眶内容物移位会导致复视。嵌顿发生后,患眼无法上抬。诊断常常困难,因为最初的眶内出血可能会限制眼球活动。华氏位体层摄影可能显示骨折,但常常仅显示上颌窦模糊不清。本文所述的肌肉牵拉试验最有帮助。手术矫正旨在用置于骨膜下的聚四氟乙烯、不锈钢网或自体骨移植片来修复缺损。通过下眼睑切口进入。如果早期修复,不会有功能丧失,而且修复后的外观效果极佳。