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Amer. Orthoptic Jrnl. 54(1):13-23 (2004); doi:10.3368/aoj.54.1.13
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Orbital Fractures: Indications and Surgical Techniques

Jill A. Foster, M.D., F.A.C.S.1,, David E.E. Holck, M.D., F.A.C.S.2 and Peter J. Koltai, M.D., F.A.C.S.3

Correspondence: Requests for reprints should be addressed to: Jill A. Foster, M.D., 340 East Town St., Columbus, OH 43215

Introduction and Purpose: Orbital fractures are common sequelae of facial trauma. They may result in diplopia, enophthalmos, infraorbital hypoesthesia, and facial asymmetry. The nature and extent of these injuries depend on a number of different factors including: severity, force, vector of the trauma, and age of the patient. The purpose of this paper is to discuss the evaluation of orbital fractures and their treatment.

Patients and Method: The management of the orbital fractures requires recognition of the fracture(s) and accurate diagnosis of both the functional and structural changes caused by the trauma. The signs and symptoms of damage to the orbital structures and to the oculomotor system and the indications for and the timing of surgical repair are discussed. The timing of the surgical intervention depends on the type of fracture, its size, the amount of entrapment of orbital tissue and the age of the patient.

Results: The surgical approach is described and the specific surgical technique for each type of fracture is covered.

Conclusions: Whatever the means used, the ultimate success of surgical intervention for orbital fractures depends upon identification of those fractures that need surgical repair, release of entrapment, restoration of the integrity and contour of the orbital walls, and an accurate clinical evaluation of the replacement volume of the orbit.

Key words: orbital fracture, trauma, diplopia, enophthalmos






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