Prognostic factors of orbital fractures with muscle incarceration

Seung Chan Lee, Seung Ha Park, Seung Kyu Han, Eul Sik Yoon, Eun Sang Dhong, Sung Ho Jung, Hi Jin You, Deok Woo Kim

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    Abstract

    Background Among the various signs and symptoms of orbital fractures, certain clinical findings warrant immediate surgical exploration, including gaze restriction, computed tomographic (CT) evidence of entrapment, and prolonged oculocardiac reflex. Despite proper surgical reconstruction, prolonged complications such as diplopia and gaze restriction can occur. This article evaluated the prognostic factors associated with prolonged complications of orbital fractures with muscle incarceration. Methods The medical records of 37 patients (37 orbits) with an orbital fracture with muscle incarceration from January 2001 to January 2015 were reviewed. The presence of Incarcerated muscle was confirmed via CT, as well as by intraoperative findings. Various factors potentially contributing to complications lasting for over 1 year after the injury were categorized and analyzed, including age, cause of injury, injury-to-operation time, operative time, fracture type, nausea, vomiting and other concomitant symptoms and injuries. Results All patients who presented with extraocular muscle limitations, positive CT findings, and/or a positive forced duction test underwent surgery. Of the 37 patients, 9 (24%) exhibited lasting complications, such as diplopia and gaze restriction. The mean follow-up period was 18.4 months (range, 1–108 months), while that of patients who experienced prolonged complications was 30.1 months (range, 13–36 months). Two factors were significantly associated with prolonged complications: injury-to-operation time and nausea/ vomiting. Loss of vision, worsening of motility, and implant complication did not occur. Conclusions Patients who present with gaze limitations, with or without other signs of a blow-out fracture, require a thorough evaluation and emergent surgery. A better prognosis is expected with a shorter injury-to-operation time and lack of nausea and vomiting at the initial presentation.

    Original languageEnglish
    Pages (from-to)407-412
    Number of pages6
    JournalArchives of Plastic Surgery
    Volume44
    Issue number5
    DOIs
    Publication statusPublished - 2017 Sep

    Keywords

    • Diplopia
    • Orbital fractures
    • Prognosis

    ASJC Scopus subject areas

    • Surgery

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