Hammond D, Grew N, Khan Z
Department of Oral and Maxillofacial Surgery, Russells Hall Hospital, Dudley, West Midlands, UK
Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton, UK.
J Surg Case Rep. 2013 Jul 12;2013(7):rjt054. doi: 10.1093/jscr/rjt054.
Inferior 'trapdoor' orbital floor fractures with muscle and soft tissue incarceration are the most common type of orbital fracture in children. Delays to treatment can lead to a significant morbidity. It has been recommended that children who present with a 'white-eyed blowout' fracture should have surgery performed within 48h of diagnosis, otherwise prognosis is poor. A 14-year-old boy was initially misdiagnosed with a head injury due to the minor appearance of his orbital injury and his presenting complaint of nausea and vomiting. This resulted in a significant delay to surgery. The oculovagal reflex associated with orbital injuries is well documented (Wei and Durairaj in Pediatric orbital floor fractures. J AAPOS 2011;15: :173-80). It should be considered by emergency department and paediatric staff when dealing with patients who have sustained a blow to the orbital region, despite not having a subconjunctival haemorrhage. The importance of examination to detect other features of orbital blow-out and entrapment are stressed.
伴有肌肉和软组织嵌顿的眶底“活板门”下壁骨折是儿童最常见的眼眶骨折类型。治疗延迟会导致严重的发病率。建议出现“白眼爆裂”骨折的儿童应在诊断后48小时内进行手术，否则预后不良。一名14岁男孩最初因眼眶损伤外观轻微以及伴有恶心和呕吐的主诉而被误诊为头部受伤。这导致了手术的显著延迟。与眼眶损伤相关的眼心反射已有充分记录（Wei和Durairaj在《小儿眶底骨折》。《美国小儿眼科与斜视学会杂志》2011年；15: 173 - 80）。急诊科和儿科工作人员在处理眼眶区域遭受打击的患者时应予以考虑，尽管没有结膜下出血。强调了检查以发现眼眶爆裂和嵌顿其他特征的重要性。
