Erbilen Esin, Yuksel Harun, Onder H Ibrahim, Tunc Murat, Kaya Murat
Hekim Sinan Medical Center, Ophtalmology Clinic, Kütahya, Turkey.
Duzce University, Faculty of medicine, Deparment of Ophtalmology, Düzce, Turkey.
Eurasian J Med. 2008 Dec;40(3):151-3.
The aim of this case report is to demonstrate that blow-out fractures can occur not only by a classical trauma mechanism but also from the consequences of a stick beat. A 66-year-old male was admitted to our hospital complaining of a sudden swelling of his right eyelid after blowing his nose. In his medical history there was the report of a hazel stick beat the previous day. Upon ophthalmological examination, ecchymosis was observed in the right orbital region, and subcutaneous amphisema in addition to a dense subconjunctival hemorrhage were detected. Using computed tomography (CT), the intraorbital air density in the soft tissues and the right maxillary sinus wall fracture possessing fluid density compatible with hemorrhage was observed. The patient was treated conservatively with prednisolone and antibiotics. We conclude that a blow-out fracture may occur in patients who experience orbital trauma, even in cases of low-energy trauma. These patients may be symptomatic after an episode of hard nose-blowing.
本病例报告的目的是证明爆裂性骨折不仅可由经典的创伤机制引起，也可由棍棒击打所致。一名66岁男性因擤鼻后右眼睑突然肿胀入院。其病史显示前一天曾被榛木棍击打。眼科检查发现右眼眶区域有瘀斑，除结膜下密集出血外还检测到皮下气肿。通过计算机断层扫描（CT）观察到软组织内眶内空气密度以及右侧上颌窦壁骨折，骨折处有与出血相符的液体密度。患者接受了泼尼松龙和抗生素保守治疗。我们得出结论，眼眶创伤患者即使是低能量创伤，也可能发生爆裂性骨折。这些患者在用力擤鼻后可能出现症状。
