Gosse Emily M, Ferguson Andrew W, Lymburn Elspeth G, Gilmour Claire, MacEwen Caroline J
Department of Ophthalmology, Ninewells Teaching Hospital and Medical School, Dundee, United Kingdom.
Br J Oral Maxillofac Surg. 2010 Jan;48(1):40-3. doi: 10.1016/j.bjoms.2009.04.028. Epub 2009 Aug 28.
The decision to repair an orbital blow-out fracture depends on several factors, but evidence for the optimum timing of surgery is not clear. We retrospectively studied all patients with orbital injuries who were referred to the eye department at a Scottish teaching hospital over a 10-year period from 1997 to 2006. We aimed to document the incidence and pattern of disturbances of ocular motility after blow-out fractures, and identify the rates of early and late resolution of these deficits, both spontaneously and after surgical repair. We found that most patients with blow-out fractures had a motility defect for an acute phase; approximately one third of which resolved spontaneously within 2 weeks. Recovery of motility after orbital surgery occurred in less than half the patients, and was not immediate. Continuing recovery also occurred in those who did not undergo surgery. Entrapment of muscle or tissue is not the only cause of motility disturbance after blow-out fractures, and orbital surgery is only one aspect of management in those patients with persistent motility defects.
修复眼眶爆裂性骨折的决定取决于多个因素，但手术最佳时机的证据并不明确。我们回顾性研究了1997年至2006年这10年间转诊至苏格兰一家教学医院眼科的所有眼眶损伤患者。我们旨在记录爆裂性骨折后眼球运动障碍的发生率和模式，并确定这些缺陷自发以及手术修复后早期和晚期的恢复率。我们发现，大多数爆裂性骨折患者在急性期存在运动缺陷；其中约三分之一在2周内自发缓解。眼眶手术后不到一半的患者运动功能恢复，且并非立即恢复。未接受手术的患者也会持续恢复。肌肉或组织嵌顿并非爆裂性骨折后运动障碍的唯一原因，眼眶手术只是那些存在持续性运动缺陷患者治疗的一个方面。
