Shin Kwang Hoon, Baek Se Hyun, Chi Mijung
Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
J Craniofac Surg. 2011 Jul;22(4):1426-9. doi: 10.1097/SCS.0b013e31821cc2cd.
We classified the outcomes of non-trapdoor-type blowout fracture repair by surgical indications and then compared the outcomes according to the time of treatment.
The medical records of 591 patients with orbital fractures that were treated surgically within 30 days of trauma were included in the study. The enrolled patients were classified into 2 groups by the major surgical indications: 1 group included patients with diplopia or limited extraocular motion, and the other group of patients had significant enophthalmos (>2 mm) or a large fracture on computed tomography (>½). The clinical outcomes were compared between the patients who received surgical repair within 14 days of trauma (early) and those who received treatment from 15 to 30 days after the trauma (delayed) in each group.
Two hundred thirty-three patients received surgical repair because of diplopia or limited extraocular motion. Both the early repaired group (n = 195) and the delayed repaired group (n = 38) showed significant improvement after surgeries. The degree of preoperative and postoperative diplopia and limited extraocular motion was not associated with differences between the 2 groups. Four hundred one patients received surgical repair because of enophthalmos (>2 mm) or a large fracture on computed tomography (>½). Both the early repaired group (n = 328) and the delayed repaired group (n = 73) showed significant improvement of the enophthalmos after surgeries. The degree of preoperative/postoperative enophthalmos did not show differences between the 2 groups.
If the blowout fracture repairs were performed within a month, the surgical outcomes did not differ according to the time of surgery in the cases of nontrapdoor blowout fracture.
我们根据手术指征对非活板门型爆裂性骨折修复的结果进行分类，然后根据治疗时间比较结果。
本研究纳入了591例在创伤后30天内接受手术治疗的眼眶骨折患者的病历。根据主要手术指征将入选患者分为2组：1组包括复视或眼球运动受限的患者，另一组患者有明显眼球内陷（>2mm）或计算机断层扫描显示大骨折（>½）。比较每组中在创伤后14天内接受手术修复（早期）的患者和在创伤后15至30天接受治疗（延迟）的患者的临床结果。
233例患者因复视或眼球运动受限接受手术修复。早期修复组（n = 195）和延迟修复组（n = 38）术后均有显著改善。术前和术后复视程度及眼球运动受限情况在两组之间无差异。401例患者因眼球内陷（>2mm）或计算机断层扫描显示大骨折（>½）接受手术修复。早期修复组（n = 328）和延迟修复组（n = 73）术后眼球内陷均有显著改善。两组术前/术后眼球内陷程度无差异。
如果在一个月内进行爆裂性骨折修复，在非活板门型爆裂性骨折病例中，手术结果不会因手术时间而有所不同。
