Yalamanchili Siri P, Ibrahim Zena A, Wladis Edward J
Department of Ophthalmology, Ophthalmic Plastic Surgery, Lions Eye Institute, Albany Medical College, Albany, New York, U.S.A.
Department of Otolaryngology, Albany Medical College, Albany, New York, U.S.A.
Ophthalmic Plast Reconstr Surg. 2024;40(2):e45-e48. doi: 10.1097/IOP.0000000000002550. Epub 2023 Nov 23.
Pediatric patients often present with orbital fractures after facial trauma, most commonly fractures of the orbital floor. Evaluation of orbital fractures for entrapment of the extraocular muscles is crucial, as urgent surgical exploration and possible repair are needed in these cases. We report a 2-year-old male who presented after a fall with multiple left orbital wall fractures, including a roof fracture. On examination, the patient's OS appeared fixed in an upward gaze. Positive forced ductions revealed clinical concern for entrapment of the superior rectus. The patient was taken to the operating room for exploration, and the entrapped superior rectus muscle was freed from the fracture. The patient subsequently recovered fully with complete extraocular movements. This represents the first reported case of superior rectus entrapment in an orbital roof fracture.
小儿患者面部外伤后常出现眼眶骨折，最常见的是眶底骨折。评估眼眶骨折时检查眼外肌有无嵌顿至关重要，因为此类病例需要紧急手术探查并可能进行修复。我们报告一例2岁男性患儿，因跌倒后出现左侧眼眶多处骨折，包括眶顶骨折。检查时，患者左眼向上注视时固定不动。强制牵拉试验阳性提示临床上怀疑上直肌嵌顿。该患者被送往手术室进行探查，嵌顿的上直肌从骨折处松解。患者随后完全康复，眼球运动完全恢复。这是首例报道的眶顶骨折伴上直肌嵌顿病例。
