The imaging features and surgical treatments of orbital blow-off fractures

Objective To study CT imaging features of orbital blow-out fractures.Methods Retrospective study and analysis was made on the clinical records of 73 orbital blow-out fracture patients from September 2009 to October 2011.Sixty-two cases with orbital fracture treated by surgical treatments and 14 cases by conservative treatments were reviewed and summarized.The condition in the diplopia,enophthalmos degree,eyeball position and imaging features were detected.The quality,position,and scope of fractures and the change of orbital cavity must be noticed,and understand the relation between orbital tissues or extraorcular muscles and fractures.Results Sixty-two cases were for operation,and 16 cases were for conservative treatment.The depressed,linear,and open fracture was seen in 39 cases of the fracture of inferior wall of orbit.Most fractures in the internal wall of orbit were depressed fracture.The enlargement of orbital cavity was found in 8 cases of fractures of internal or inferior wall of orbit.The shape,position and secondary changes of extraocular muscles were detected by CT scan,which was confirmed by surgery.Even emergency operations treatment should be taken to the children who had orbit linear fracture with the symptom of incarcerated extraocular muscle,diplopia,nausea and vomiting.The conservative treatment for the patients was effective.Conclusions It is necessary to master the treatment indications strictly,and to relax the adhesive extraorcular and fiber rope according to the imaging features,which can be effective to recover the function of extraocular muscles and alleviate the diplopia of patients. Key words: Blow-out fractures;  Imaging diagnosis;  CT scan;  Conservative treatment;  Surgical indications