Balaraman Kannan, Patnaik J Sai Santosh, Ramani Vimalambiga, Bhat Keerthana, Thomas Devdutt, Bharathi R Ravindra, Sabapathy S Raja
Department of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery, Facio Maxillary Surgery, Aesthetic Surgery, Oncoplastic Breast Surgery and Burns, Ganga Hospital, Coimbatore, India.
J Maxillofac Oral Surg. 2021 Mar;20(1):37-41. doi: 10.1007/s12663-020-01393-0. Epub 2020 Jun 22.
Diplopia in children is uncommon. However a small group of patients present with diplopia and severe restriction of upward globe movement which requires early diagnosis and prompt intervention. This study aims to evaluate the timing of intervention and functional outcome in the management of white-eyed blowout fractures.
The study was conducted in a tertiary level trauma center. There were a total of 46 orbital floor injuries over a period of 2 years out of which 4 patients with white-eyed blowout fractures were identified. Details of each case were entered on a standard data base and analysed with respect to age, mode of injury, extent of limitation of gaze, timing of intervention, pre and post-operative diplopia. Minimum follow up period for every case was 1year.
All of them had sports related injuries. Three of the four patients had complete recovery from diplopia with full range of eye movements. However one child with delayed presentation didn't recover fully and had persistence of symptoms within the functional range.
White-eyed orbital blowout fracture in kids though uncommon need prompt diagnosis and management for complete recovery. The initial clinical presentation mimics that of head injury and hence can be missed, leading to a delay in diagnosis resulting in incomplete recovery.
儿童复视并不常见。然而，一小部分患者会出现复视以及严重的眼球向上运动受限，这需要早期诊断和及时干预。本研究旨在评估白眼爆裂性骨折治疗中的干预时机和功能预后。
该研究在一家三级创伤中心进行。在两年时间里，共有46例眶底损伤病例，其中4例被确诊为白眼爆裂性骨折。每个病例的详细信息被录入一个标准数据库，并就年龄、受伤方式、注视受限程度、干预时机、术前和术后复视情况进行分析。每个病例的最短随访期为1年。
所有患者均有与运动相关的损伤。4例患者中有3例复视完全恢复，眼球运动范围正常。然而，1例就诊延迟的患儿未完全恢复，在功能范围内仍有症状持续存在。
儿童白眼眶爆裂性骨折虽不常见，但需要及时诊断和治疗以实现完全恢复。其初始临床表现与头部损伤相似，因此可能被漏诊，导致诊断延误，进而恢复不完全。
