暴裂性眶壁骨折临床分析

经CT确诊暴裂性眶壁骨折 16例 ,其中眶内壁 11例 ,眶下壁 3例 ,眶上壁 1例 ,眶内壁合并上下壁 1例。非手术治疗 11例 ,手术治疗 5例。各种器具伤和车祸为好发因素 (占 37.5 %和 31.3% )。男性青壮年好发原因与其从事工作性质有关。临床主要表现为复视、眼球内陷和眼球运动障碍。CT显示眶壁结构破坏、移位 ,眶腔增大 ,眶软组织移位及副鼻窦改变。非手术治疗 11例 ,全部临床治愈。手术治疗 5例 ,3例治愈 ,2例好转。提示暴裂性眶壁骨折引起眶壁骨组织破坏导致眼眶组织解剖异常 ;CT能明确显示眶壁结构破坏及眶组织、副鼻窦损伤的变化 ,对骨折定位诊断及治疗有重要意义。眶壁骨折应积极采用非手术方法治疗 ;是否手术治疗取决于骨折缺损区对眶组织重要器官的影响 ,手术时机最好在伤后 1～ 2周内

Clinical analysis of blowout fractures of the orbit

Sixteen patients with blowout fractures of the orbit, proven by CT, were analysed. Eleven were of the internal orbit, three of the inferior wall of the orbit, one of the root of orbit, and one of the internal orbit in combination with the root and inferior wall of the orbit. Eleven received non-surgical treatment and five surgical treatment. The major factors were a variety of tools injury and traffic accidents (37.5% and 31.3%, respectively). The reason that more young males easily got this injury may be related to their professions. The clinical manifestations were diplopia, endophthalmos, and eye movement disturbance. The injured and displaced orbital wall structures, the enlarged eyeball socket, displaced orbital soft tissues and paranasal sinuses changes could be found on CT scanning. All the eleven patients with non-surgical treatment were cured. As for the five with surgical treatment, three were cured and two improved. This study indicates that blowout fractures of the orbit results in a bony tissue lesion which changes the anatomical structure of orbital tissue. CT can expose orbital wall structural lesions, changes of orbital tissues and paranasal sinus lesions, so it is of great significance for diagnosis, localization and treatment of fractures. Patients with fractures of the orbit should receive non-surgical treatment first; the surgical treatment depends on the level of fracture affecting the major organs of orbital tissue and it should be carried out within 1～2 weeks.