Abumanhal Muhammad, Miyazaki Hidetaka, Takahashi Yasuhiro
Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.
Jpn J Ophthalmol. 2025 Aug 20. doi: 10.1007/s10384-025-01268-2.
To analyze differences in demographics, etiology, and clinical characteristics between pure and impure orbital fractures (with or without orbital rim involvement) STUDY DESIGN: Retrospective observational study.
A total of 1104 cases of orbital fractures were reviewed. Fractures were classified as pure (881 cases) or impure orbital fractures (223 cases). Impure fractures were further subdivided into frontal bone (14 cases), zygomaticomaxillary complex (ZMC, 187 cases), and multiple (22 cases) fractures. Data on demographics, fracture types, injury mechanisms, field of binocular single vision (BSV), and associated ocular injuries were analyzed across the groups.
Patients with ZMC fractures were older than those with orbital or frontal bone fractures (P <.001 and P = .007). Bilateral fractures were more frequent in the multiple-fractures group (P <.001). Falls were the leading cause of injury (39%), particularly in ZMC fractures (52%). Motor vehicle accidents accounted for 50% of multiple fractures. The overall rate of ocular injuries was 7.3%, with all globe ruptures (5 cases) occurring in the pure fracture group. Multiple fractures had higher incidences of optic canal fractures and orbital compartment syndrome (P <.001). Frontal bone fractures demonstrated better BSV outcomes, whilst multiple fractures had the worst.
This large-scale study highlights the significant influence of age and injury mechanisms on orbital fracture patterns. Frontal bone fractures were associated with more favorable visual function, whilst pure fractures posed greater risk of globe rupture. These findings underscore the importance of tailoring management strategies to specific fracture types and patient demographics.
分析单纯性与非单纯性眼眶骨折（伴或不伴有眶缘受累）在人口统计学、病因及临床特征方面的差异。研究设计：回顾性观察研究。
共回顾了1104例眼眶骨折病例。骨折分为单纯性（881例）或非单纯性眼眶骨折（223例）。非单纯性骨折进一步细分为额骨骨折（14例）、颧上颌复合体（ZMC）骨折（187例）和多发性骨折（22例）。对各分组的人口统计学数据、骨折类型、损伤机制、双眼单视（BSV）范围及相关眼外伤情况进行分析。
ZMC骨折患者比眼眶或额骨骨折患者年龄更大（P<.001和P =.007）。多发性骨折组双侧骨折更为常见（P<.001）。跌倒为主要致伤原因（39%），尤其在ZMC骨折中（52%）。机动车事故占多发性骨折的50%。眼外伤总发生率为7.3%，所有眼球破裂病例（5例）均发生在单纯性骨折组。多发性骨折的视神经管骨折和眼眶间隔综合征发生率更高（P<.001）。额骨骨折的BSV结果较好，而多发性骨折最差。
这项大规模研究突出了年龄和损伤机制对眼眶骨折类型的显著影响。额骨骨折与更有利的视觉功能相关，而单纯性骨折导致眼球破裂的风险更高。这些发现强调了根据特定骨折类型和患者人口统计学特征制定治疗策略的重要性。
