Wilkins R B, Havins W E
Ophthalmology. 1982 May;89(5):464-6. doi: 10.1016/s0161-6420(82)34767-3.
Blow-out fracture repair and its timing have been controversial. Originally all x-ray proven fractures were repaired regardless of size or symptoms. Later a controversial report of a large series of cases indicated repair to be unnecessary. Today, x-ray proven fractures with enophthalmos justify surgery, but double vision alone is insufficient. Observation of improving diplopia for several days is suggested. Evaluation of x-rays, enophthalmos, diplopia with restriction, and facial anesthesia are recommended before surgery. Recognition of diagnostic signs and symptoms, as well as potential severe cosmetic and functional complications, have aided the approach to the decision for or against fracture repair.
眼眶爆裂性骨折的修复及其时机一直存在争议。最初，所有经X线证实的骨折，无论大小或症状如何，均进行修复。后来，一份关于大量病例的有争议报告表明无需修复。如今，经X线证实伴有眼球内陷的骨折需要手术治疗，但仅复视则不足以作为手术指征。建议观察数天看复视是否改善。术前推荐对X线、眼球内陷、伴有眼球运动受限的复视以及面部感觉进行评估。对诊断体征和症状的认识，以及潜在的严重美容和功能并发症，有助于做出骨折修复与否的决策。
