Orbital Roof Fractures as an Indicator for Concomitant Ocular Injury
59th Medical Wing San Antonio United States
Pagination or Media Count:
Purpose Orbital roof fractures are a significant cause of morbidity in trauma and are associated with a spectrum of orbital and ocular injuries. This study aims to characterize orbital roof fracture patterns and quantify the rate of acute intervention as compared to nonroof involving orbital wall fractures. Methods This study is a retrospective analysis of 340 orbital wall fractures diagnosed by CT imaging from August 2015 to October 2016. Orbital wall fractures were categorized as roof involving NSO and non-roof involving N290. Comparisons were made between these two groups to indicate a statistically significant difference in mechanism of injury, subjective symptoms, CT and exam findings, and final plan of care to include acute ophthalmologic intervention at the time of consultation. Results Assault 40.7 was the most common cause of non-roof involving fractures while falls from height 20.0 were associated with a higher rate of roof fractures. Roof involving orbital wall fractures were associated with a higher prevalence of corneal abrasions 16.3, lid lacerations 23.4, and traumatic optic neuropathy 10.4. A reliable subjective exam on initial ophthalmic consultation was not achieved in a larger proportion of roof fracture patients 30. Despite this, the rate of acute intervention in this group 34 was almost double, including lateral canthotomy and cantholysis. Conclusion Concomitant ocular injury is common in roof involving orbital wall fractures, and may require more urgent ophthalmologic evaluation and acute intervention. As subjective patient data is often less readily available, a high index of suspicion and thorough investigation is warranted in caring for patients with roof involving orbital wall fractures.
- Medicine and Medical Research