Centre for Oral & Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.
PLoS One. 2018 Oct 5;13(10):e0204946. doi: 10.1371/journal.pone.0204946. eCollection 2018.
The aim of this study was to determine the predictors of post-traumatic enophthalmos (PE) in relation to the internal orbital changes following pure orbital blowout fractures. The design was a 10-year retrospective cross-sectional study analysing 629 medical records and computed tomography (CT) data of patients with orbital fractures from January 2008 to January 2017. Demographic, etiology, co-morbidity and clinical characteristics were obtained from the medical records. Assessment of the PE, fracture site and size, intraorbital structures and muscle change were performed using the Digital Imaging and Communications in Medicine (DICOM) viewer software, OsiriX v5.8.2. Of the 629 patients with orbital fractures, 87 were pure orbital blowout fractures. Demographic pattern showed that males outnumbered females in the series, with male: female ratio of 5.7:1. The mean age was 37.2 ± 14.7 and the main etiology was motor vehicle accident. Orbital floor fracture was the most common fracture location (67.8%). The involvement of the posterior ledge and inferior orbital fissure showed statistical significant difference with PE (Fisher's exact test, p = 0.03). Binary logistic regression showed that after controlling for age, patients with fracture size of more than 150 mm2 had three times the odds of sustaining a PE, (adjusted odds ratio (AOR) = 3.01 (95% CI 1.17-7.92). Fracture size larger than 150 mm2 was a radiological predictor of PE. Additional research investigating further on the role of concurrent fracture of the posterior ledge and inferior orbital fissure is advocated.
本研究旨在确定与单纯眶爆裂性骨折后眼内陷（PE）相关的眼眶内变化的预测因素。设计为回顾性 10 年横断面研究，分析 2008 年 1 月至 2017 年 1 月期间 629 例眼眶骨折患者的病历和计算机断层扫描（CT）数据。从病历中获取人口统计学、病因、合并症和临床特征。使用数字成像和通信医学（DICOM）查看器软件、OsiriX v5.8.2 评估 PE、骨折部位和大小、眶内结构和肌肉变化。在 629 例眼眶骨折患者中，87 例为单纯眶爆裂性骨折。人口统计学模式显示，该系列中男性多于女性，男女比例为 5.7:1。平均年龄为 37.2 ± 14.7，主要病因是机动车事故。眶底骨折是最常见的骨折部位（67.8%）。后缘和下眶裂受累与 PE 有统计学显著差异（Fisher 精确检验，p = 0.03）。二元逻辑回归显示，在控制年龄后，骨折面积大于 150 mm2 的患者发生 PE 的几率增加了三倍（调整比值比（AOR）= 3.01（95%置信区间 1.17-7.92）。骨折面积大于 150 mm2 是 PE 的影像学预测因素。提倡进一步研究后缘和下眶裂并发骨折的作用。
