Ballim Shaheer, Gundry B, Mahomed S, Visser L
Department of Ophthalmology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
S Afr J Surg. 2013 Oct 22;51(4):134-7. doi: 10.7196/sajs.1667.
To describe cases of intra-orbital knife blade foreign body following stabs to the orbit, together with a novel technique for removal.
Retrospective case series of 3 patients.
All 3 patients had knife blades embedded in the orbit as a result of assault. The blades assumed the same direction within the orbit with varying degrees of depth, one causing serious vascular injury. In 2 cases the globes were intact after foreign body removal, with good visual outcomes. The third patient required enucleation. Two of the 3 knife blades were removed using a 'double bone nibbler' technique. The third was embedded without a handle and required removal with minor manipulation of the globe.
Thorough investigation for vascular injury must be done before any attempted surgical removal. Visual outcomes can be good after removal of a knife blade foreign body. The double bone nibbler technique is promising for the controlled removal of embedded blades that are rigidly fixed.
描述眼眶刺伤后眶内刀片异物的病例,并介绍一种新的取出技术。
对3例患者进行回顾性病例系列研究。
所有3例患者均因袭击导致刀片嵌入眼眶。刀片在眼眶内方向相同,但深度不同,其中1例造成严重血管损伤。2例患者在取出异物后眼球完整,视觉效果良好。第3例患者需要摘除眼球。3例中的2例刀片采用“双咬骨钳”技术取出。第3例刀片无刀柄嵌入,需对眼球进行轻微操作才能取出。
在尝试任何手术取出之前,必须对血管损伤进行全面检查。取出刀片异物后视觉效果可能良好。双咬骨钳技术有望用于可控地取出牢固固定的嵌入刀片。