Mehta Viraj J, Chelnis James G, Chen Qingxia, Mawn Louise A
Vanderbilt Eye Institute.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Ophthalmic Plast Reconstr Surg. 2018 Jul/Aug;34(4):351-354. doi: 10.1097/IOP.0000000000000993.
To evaluate the relationship between time to surgical intervention and extraocular motility outcomes in children following repair of an orbital floor fracture with inferior rectus entrapment.
After institution review board's approval, a retrospective, consecutive case series of 28 children with unilateral orbital floor fractures entrapping the inferior rectus muscle was conducted. Clinical examinations and CT images were performed on all children. The main outcomes measures were postoperative motility measurements.
Eleven patients underwent surgery within 24 hours of reported injury, while 17 patients underwent surgery after 24 hours. There was no statistically significant difference in average age at the time of surgery (p = 0.47) or average preoperative motility scores (p = 1.0) between the 2 groups. Patients who underwent surgery within 24 hours of reported injury had an improved likelihood of recovery (log hazard ratio = 0.469; 95% confidence interval, -0.42 to 1.36).
Our exploratory study suggests that surgical reduction of inferior rectus entrapment in pediatric orbital floor fractures within 24 hours from the time of injury shows an improved, but nonstatistically significant, likelihood of recovery in motility deficits with earlier surgical intervention.
评估小儿眶底骨折伴下直肌嵌顿修复术后手术干预时间与眼外肌运动结果之间的关系。
经机构审查委员会批准，对28例单侧眶底骨折伴下直肌嵌顿的小儿进行回顾性连续病例系列研究。对所有患儿进行临床检查和CT扫描。主要结局指标为术后运动功能测量。
11例患者在受伤后24小时内接受手术，17例患者在受伤24小时后接受手术。两组患者手术时的平均年龄（p = 0.47）或术前平均运动功能评分（p = 1.0）无统计学差异。受伤后24小时内接受手术的患者恢复可能性更大（对数风险比 = 0.469；95%置信区间，-0.42至1.36）。
我们的探索性研究表明，小儿眶底骨折伴下直肌嵌顿伤后24小时内进行手术复位，早期手术干预可提高运动功能障碍恢复的可能性，但无统计学意义。
