比较儿童/青少年和成年人眶壁爆裂性骨折伴眼球内陷治疗结果。

Comparison of the results of the treatment of enophthalmos in orbital blowout fracture in children/adolescents and adults.

机构信息

Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Kraków, Poland.

出版信息

Dent Med Probl. 2021 Apr-Jun;58(2):179-186. doi: 10.17219/dmp/130815.

DOI:10.17219/dmp/130815

PMID:34036756

Abstract

BACKGROUND

Orbital fractures are common injuries in adults and children. Although the mechanism of blowout fracture is generally similar regardless of age, due to differences in anatomy, clinical symptoms of these fractures vary in the 2 groups of patients. Numerous articles describe the methods of orbital reconstruction leading to enophthalmos correction; however, the current literature lacks articles presenting the comparison of enophthalmos treatment results in adults and children with orbital blowout fracture.

OBJECTIVES

The aim of this study was to compare the results of the treatment of enophthalmos in orbital blowout fracture in children/adolescents and adults with regard to the location of the fracture, the time from the injury to surgical treatment, the type of surgical procedure, and the donor location of an autogenous bone graft.

MATERIAL AND METHODS

The treatment results of 2 groups were compared: 530 adults (patients over 18 years of age; 18-77 years; average age: 34 years); and 200 children/adolescents (4-18 years; average age: 12.1 years). Data was obtained retrospectively through a review of the medical history of patients treated for a fracture of the orbital floor and/or medial wall in our department in the years 1975-2015.

RESULTS

In patients with post-traumatic enophthalmos, the correct positioning of the eyeball was achieved in 313 adults (59.1%) and 139 children (69.5%), improvement in 159 adults (30%) and 49 children (24.5%), and no improvement in 58 adults (10.9%) and 12 children (6%). Recovery after surgical treatment was achieved in 311 adults (60.9%) and 94 children (52.8%), improvement in 120 adults (23.5%) and 59 children (33.1%), and no improvement in 80 adults (15.7%) and 25 children (14%).

CONCLUSIONS

The relationship between post-traumatic enophthalmos and the location of the fracture was more significantly marked in the adult group. In cases that required bone graft reconstruction, better results were achieved in adults. Cite as.

摘要

背景

眼眶骨折在成人和儿童中均较为常见。尽管爆裂性骨折的机制在不同年龄段通常相似，但由于解剖结构的差异，这两组患者的骨折临床症状存在差异。许多文章描述了导致眼球内陷矫正的眼眶重建方法；然而，目前的文献缺乏比较成人和儿童爆裂性眼眶骨折眼球内陷治疗结果的文章。

目的

本研究旨在比较儿童/青少年和成人眼眶爆裂性骨折伴眼球内陷患者的骨折位置、受伤至手术治疗的时间、手术类型以及自体骨移植供骨部位等因素对眼球内陷治疗结果的影响。

材料和方法

比较了两组患者的治疗结果：530 例成人（年龄＞18 岁；18-77 岁；平均年龄：34 岁）；200 例儿童/青少年（4-18 岁；平均年龄：12.1 岁）。通过回顾性分析 1975 年至 2015 年在我科治疗眼眶底壁和/或内侧壁骨折的患者的病历资料，获得了相关数据。

结果

在创伤后眼球内陷的患者中，313 例成人（59.1%）和 139 例儿童（69.5%）眼球位置得到正确定位，159 例成人（30%）和 49 例儿童（24.5%）眼球内陷得到改善，58 例成人（10.9%）和 12 例儿童（6%）眼球内陷无改善。311 例成人（60.9%）和 94 例儿童（52.8%）术后获得了恢复，120 例成人（23.5%）和 59 例儿童（33.1%）眼球内陷得到改善，80 例成人（15.7%）和 25 例儿童（14%）眼球内陷无改善。