Diplopia in fractures of the orbital floor

Based on their own experience with surgical treatment of 43 patients with fractures of the orbital floor, the authors discuss the problem of early operation in relation to the development of residual diplopia. They evaluate the functional result by the size of the visual field where diplopia occurred. In confirmed fractures of the orbit they recommend operation as early as possible after the injury. All patients were operated by the method of transantral reposition of the orbital floor. Satisfactory functional results were achieved in all operated patients. None of them had diplopia in the primary position of the eyes. The best results were achieved in patients operated early (residual diplopia in 10%), where none of the patients had diplopia in the visual field beneath 30 degrees.     

爆裂性眼眶骨折骨缺损修复的临床观察

目的探讨眼眶骨折骨缺损修复材料的性能。方法采用不同的修复材料:如自体骨、羟基磷灰石、医用硅胶等,分别填充于眶壁骨折缺损处,比较三种物质术后反应情况。结果自体骨术后反应轻,组织相容性好,愈合快,无排异,愈合后无硬节。结论自体骨是眶壁骨折骨缺损修复的最佳材料。     

Complications following orbital floor fractures

Complications after orbital floor fractures were studied in 76 cases (follow-up time 4 years). The following procedures were performed by the maxillofacial surgeon: repositioning of the orbital floor, tamponade of the maxillary sinus, covering of the defect with Lyodura, autologous bone grafting, and balloon catheterization. A satisfactory result was achieved after the primary operation in 75% of the cases. In cooperation with the ophthalmologist a variety of complications in 19 patients were studied and analyzed. The results of this study show the necessity of diagnostic and surgical cooperation between the specialists concerned.     

Management of blow-out fractures of the orbital floor

The management of orbital fractures has long been controversial. In some cases, surgical repair is required, and early repair is more successful than secondary reconstruction. In other cases, slow resolution of diplopia over four to six months obviates surgery. In an editorial and two separate articles, the authors elucidate indications for and results of the early vs. late surgical repair of orbital blow-out fractures.     

Orbital floor fractures and their treatment

Orbital floor fractures can occur with or without any associated fractures of the middle third of the facial skeleton. Fifty-one patients with a unilateral "black eye" after motor vehicle accidents were reviewed. The fractures involving the orbital floor were analysed. The clinical signs and symptoms, with results of radiological examination, are discussed. The various treatment modalities and their postoperative complications are discussed.     

高密度多孔聚乙烯种植体修复眼眶下壁骨折

目的探讨高密度多孔聚乙烯种植体（Medpor）修复眶下壁骨折效果。方法做睫毛下切口,充分暴露眼眶骨折部位、松解嵌顿的眶内容物,骨膜下填充Medpor修复眶下壁骨折。观察术后复视、眼球运动、眼球内陷等症状改善情况及植入物有无脱出及感染。结果随访期内未出现Medpor脱出或排斥现象。全部21例（21只眼）术后均无明显的眼球内陷,19眼复视消失,2眼复视明显改善。结论Medpor填充是眶下壁骨折有效治疗方法。     

小儿眶底骨折临床分析

目的 :探讨小儿眶底骨折的临床特点及治疗。方法 :回顾性研究 6 7例年龄小于 18岁的单纯眶底骨折患者 ,采用手术治疗眶底骨折 ,植入物为硅胶或羟基磷灰石。结果 :体育运动 (37 3% )和暴力伤 (2 3 9% )是造成小儿眶底骨折的主要原因 ;79 1%的病人有眼球运动疼痛和 /或恶心呕吐 ,复视 (79 7% ) ,严重的眼球运动障碍 (6 1 2 % )和眼球内陷 (2 5 4% )。小儿眶底骨折主要是陷阱型 (trapdoortype)骨折 (5 6 8% ) ,可伴有下直肌嵌顿。早期手术 (<1个月 )比晚期手术 (>1个月 )可以更有效地改善患者症状 (P <0 0 5 )。结论 :早期手术是治疗小儿眶底骨折的有效方法