Comparison of Postoperative Results of Blowout Fracture by Types of Fractures

Abstract

Abstract: : Purpose: There are several types of blowout fractures; however, the consequences are various. In this study, we analyzed the postoperative results of blowout fractures using novel diplopia quantitative analysis system. Methods: Sixteen cases of blowout fractures were selected in Dokkyo University hospital. The patients were classified into 3 different fracture types (trap door type, bone defect type and a muscle caught type). The fracture parts were reconstructed from the maxillary side and orbit side together. After the reconstruction, the orbital floors were covered using autologous periosteum from tibia. The patients were followed up for more than one year. For evaluations of diplopia, we performed Hess red green examinations for each case preoperatively (1, 3, 6 and 12 months). To analyze the results of Hess red green examinations, we used image analysis software (Sion image) and the changes of diplopia were calculated quantitatively at the selected time periods. Results: After the operation, the diplopia were decreased in all patients using novel diplopia quantitative analysis systems. The recovery from diplopia was excellent in patients of trap door type and bone defect type. However, the recovery was less in the muscle caught type after surgery. The early stage operation may be more effective for the muscle caught type. Conclusions: The novel diplopia quantitative system using Scion image is effective for evaluation of blowout flactures. The surgery using autologous periosteum from tibia for reconstruction of orbital floor is great results for treatment of blowout fluctures.

Keywords: orbit • trauma • ocular motor control