Publication date: Available online 26 February 2019
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Ramakrishnan Karthik, Scott Cynthia, Narayanan Vivek, Chandran Saravanan, Gurram Prashanthi
Abstract
Purpose
Orbital trapdoor fractures may constitute a relative surgical emergency. The reason for poor surgical outcomes in ocular motility disturbances and diplopia is not apparent in these fractures. The purpose of this retrospective study was to analyze the possibility of ischemic necrosis of the orbital contents in linear trapdoor fracture of the orbital floor and to evaluate the recovery period of trapdoor fractures.
Patients And Methods
The study included 11 patients with linear trapdoor fracture of the orbital floor in five years with a minimum of one year follow up. Patients with associated facial bone fractures were excluded. The demographic, etiologic, radiologic, interval between trauma and surgery and surgical techniques were recorded.
Results
The age range was 9 to 29 years with the mean being 16.3 years. The mean time to surgical intervention from the time of injury was 3.9 days (range 0-11). Intraoperatively we observed macroscopic segmental necrosis of the entrapped inferior rectus muscle in 3 patients. Post operative review was conducted for a minimum of 12 months at the interval of 1st week, one month, 3 months, 6 months and 12 months. At the end of the follow-up period, incomplete recovery was observed in five patients which included all the three patients with intraoperative necrosed muscle and the other two patients were operated at 7th day and 8th day from the time of injury.
Conclusion
From our study, we observed that segmental necrosis of the entrapped inferior rectus muscle is possible in linear trapdoor fracture of the orbital floor. We also noted that incomplete recovery correlates with clinical evidence of inferior rectus muscle necrosis and late surgical intervention.
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