Orbital fracture
Introduction
Introduction to orbital fracture Eyelid fractures can occur alone, or with other maxillofacial fractures, such as humeral fractures, frontal bone fractures, or maxillary LeFort II, III fractures. Clinically encountered tibiofibular fractures include humeral fractures, superior temporal margin fractures, dome fractures, and internal and external wall fractures. The fractures of the sacral floor have certain characteristics in diagnosis and treatment. basic knowledge The proportion of illness: 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: eyeballs
Cause
Cause of orbital fracture
External impact (75%)
The fracture of the sacral floor is weak, mainly composed of the maxillary condyle, that is, the upper wall of the maxillary sinus. The lateral part is the tremoric condyle. The bottom of the sac is a sloping plane extending upwards and backwards. The posterior part is a weak area with submental and axillary The crack passes through, and the area is connected with the sieving board to form the inner and lower walls of the bottom of the sputum. The thin inner layer is like a paper. When the middle part of the surface is broken by an external force, the bottom of the sputum impacts, causing a sharp increase in the internal pressure of the iliac crest. Fracture of orbital floor), this type of fracture is also called a blowout fracture. Because the underside of the sac is the maxillary sinus, the fracture of the sacral floor often causes the sputum to break into the upper sinus.
Prevention
Eyelid fracture prevention
Prevent facial trauma. Surgical treatment should be timely. The operation period is about 1 week after the injury. Because of the premature operation, the tissue in the injured area is not swollen. In the late stage, the wound has been misplaced or scarred, and it is difficult to achieve satisfactory results.
Complication
Eyelid fracture complications Complications
The eyeball is trapped at the bottom of the eye, the eye movement is limited, the underarm nerve distribution area is numb, and the visual impairment is.
Symptom
Eyelid fracture symptoms Common symptoms Eye pain Eyebrow drooping or position Low eyeball tenderness Blood stasis Visual eyeball Highlight eyeball Retraction Internal hemorrhage
1. A history of traumatic history of a blunt instrument with a larger blunt instrument than the eyelid or a multiple fracture of the midface of the face should be noted.
2, the middle of the fracture in the face of the injured with eyeball depression and double vision.
3, the lower rectus muscle traction test positive after the cardia anesthesia conjunctiva, with ophthalmology have gums, through the conjunctiva sandwich the inferior rectus tendon, for the pull test, such as eyeball up-constrained, it is positive, indicating straight The muscles are depressed.
4, X-ray film examination can choose to take the Fahrenheit or the tomogram, observe the sacral cavity, the sacral floor and the maxillary sinus.
Clinical manifestations:
1, phlegm and blood stasis, swelling can be used subcutaneous and subconjunctival hemorrhage, such as hemorrhage in the sputum, can make the eyeball prominent, often at the lower edge of the sac can touch the steps, there is tenderness.
2, eyeball depression is an important sign of the sacral fracture, the main cause of eye depression is: 1 due to sacral fracture, sputum content with the eyeball down or into the maxillary sinus cavity; The position increases the sacral cavity and the amount of fat in the sputum supports the eyeball.
3, double vision burst fracture, the sacral fossa including the subocular rectus muscle, the inferior oblique muscle and the fascia fascia are downwardly displaced, so that the extraocular muscles appear restricted in vertical movement and produce diplopia, such as oculomotor nerve Damage can also cause double vision.
4. The fracture piece of the numbness fracture in the infraorbital area often hurts or compresses the infraorbital nerve, causing numbness in the innervation area.
Examine
Eyelid fracture examination
1. Test and examination: the lower rectus muscle pull test is positive. After the anesthesia is conjunctiva, the ophthalmology has a gingival sac, and the inferior rectus tendon is clamped through the conjunctiva for a pulling test. If the eyeball is restricted, it is positive. , indicating that the lower rectus muscle has a depression.
2. Laboratory examination: X-ray examination, optional Fahrenheit or tomography, observation of the sacral cavity, sacral floor and maxillary sinus.
Diagnosis
Diagnosis and diagnosis of orbital fracture
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations. Those with a blunt instrument larger than the eyelids that hit the eye or cause multiple fractures in the middle of the face should pay attention to the presence or absence of a sacral fracture. In the middle of the fracture, the injured person with eyeball depression and double vision, the lower rectus muscle pull test positive and X-ray examination can be diagnosed.
Differential diagnosis
Identification with a blown fracture.
