5,839 results match your criteria Fracture Orbital


Orbital reconstruction: a systematic review and meta-analysis evaluating the role of patient-specific implants.

Oral Maxillofac Surg 2022 May 20. Epub 2022 May 20.

Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, London, UK.

The purpose of this study is to execute an evidence-based review answering the following question (PICO): "Do patient-specific implants (PSI), manufactured or designed using computer-assisted technology, improve outcomes (orbital volume change, enophthalmos, diplopia, and operative duration) compared to conventional methods in orbital reconstruction following traumatic orbital injury in the adult patient population?" We performed a systematic review and meta-analysis in accordance with PRISMA guidelines. Inclusion criteria included any comparative paper whereby computer-assisted technology was used in the prefabrication or design process of implants for use in post-traumatic orbital reconstruction. Paediatric patient populations were excluded. Read More

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Reflections on a patient-centered approach to treatment of blow-out fractures: Why the wisdom of the pastmust guide our decision-making.

Authors:
Paolo Scolozzi

J Plast Reconstr Aesthet Surg 2022 Apr 25. Epub 2022 Apr 25.

Head, Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland. Electronic address:

The management of blow-out orbital fractures (BOFs) continues to be controversial and regularly questioned. In recent years, treatment decision-making has shifted from a clinically dominated emphasis to a more objective data-based approach. This has come about through the refinement of imaging technologies that can more precisely define the fracture itself. Read More

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Primary reconstruction of extensive orbital fractures using two-piece patient-specific implants: the Helsinki protocol.

Oral Maxillofac Surg 2022 May 18. Epub 2022 May 18.

Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4E, 00029 HUS, Helsinki, Finland.

Purpose: We present our experience of titanium-milled two-piece patient-specific implants (PSIs) for primary reconstructions of extensive orbital floor and medial wall fractures (EOFMFs) and evaluate their postoperative functional and aesthetic outcomes in relation to commercially available implants.

Methods: We included all patients with primary reconstructions (< 22 days from injury) of EOFMFs treated in our department between January 2011 and October 2020. Extensive orbital floor and medial wall fracture was defined as involvement of orbital floor, medial wall and maxilloethmoidal junction; a fracture defect 5 mm or more; defect size more than a third of both inferior and medial walls; and Jaquiéry classification III or more. Read More

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Pattern of oral and maxillofacial trauma and associated factors: An 8-year prospective study.

Dent Traumatol 2022 May 18. Epub 2022 May 18.

Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Pernambuco, Recife, Brazil.

Background/aims: Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service.

Materials And Methods: A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Read More

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Eye Injuries Caused by Wooden Projectiles in Finland.

Wilderness Environ Med 2022 May 13. Epub 2022 May 13.

University of Helsinki and Helsinki University Eye Hospital, Helsinki, Finland.

Introduction: Eye injuries can cause decreased vision or even blindness, and predispose to future complications. Wood as an independent cause of eye injuries has infrequently been the focus of the studies. The aim of this study is to report the current population-based epidemiology, treatment, use of resources and outcomes of eye injuries caused by sticks, branches, and other wooden projectiles in Finland. Read More

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Meat tenderizer assault and associated facial trauma: A case report.

Trauma Case Rep 2022 Jun 27;39:100648. Epub 2022 Apr 27.

University of Nebraska Medical Center, Department of Otolaryngology-Head and Neck Surgery, 981225 Nebraska Medical Center, Omaha, NE 68198-1225, United States of America.

Background: Blunt trauma to the face, head and neck is frequently encountered in violent assaults (Brink, 2009 [1]). There can be trauma to the cranium in high energy mechanisms, though interpersonal trauma is less likely to be associated with traumatic brain injury (TBI) (Salentijn et al., 2014 [2]). Read More

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The Incidence and Risk Factors of Medial and Inferior Orbital Wall Fractures in Korea: A Nationwide Cohort Study.

J Clin Med 2022 Apr 21;11(9). Epub 2022 Apr 21.

Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea.

Purpose: We aimed to investigate orbital wall fracture incidence and risk factors in the general Korean population.

Method: The Korea National Health Insurance Service-National Sample Cohort dataset was analyzed to find subjects with an orbital wall fracture between 2011 and 2015 (based on the diagnosis code) and to identify incident cases involving a preceding disease-free period of 8 years. The incidence of orbital wall fracture in the general population was estimated, and the type of orbital wall fracture was categorized. Read More

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Is Surgery Needed for Diplopia after Blowout Fractures? A Clarified Algorithm to Assist Decision-making.

Plast Reconstr Surg Glob Open 2022 May 9;10(5):e4308. Epub 2022 May 9.

Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.

Diplopia is a common symptom after blowout fractures, with an incidence of 43.6%-83%. Although there is some consensus toward surgical correction, diplopia is not always resolved by surgery. Read More

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Preliminary outcomes of the surgical navigation system combined with intraoperative three-dimensional C-arm computed tomography for zygomatico-orbital fracture reconstruction.

Sci Rep 2022 May 12;12(1):7893. Epub 2022 May 12.

Division of Trauma Plastic Surgery, Department of Plastic and Reconstructive Surgery, Craniofacial Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 5 Fuxing Street, Taoyuan, 333, Taiwan.

This study analyzed the outcomes of zygomatico-orbital fracture reconstruction using the real-time navigation system with intraoperative three-dimensional (3D) C-arm computed tomography (CT). Fifteen patients with zygomatico-orbital or isolated orbital/zygoma fractures were enrolled in this prospective cohort. For zygoma reduction, the displacement at five key sutures and the differences between preoperative and intraoperative CT images were compared. Read More

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Secondary Correction of Posttraumatic Enophthalmos.

Facial Plast Surg 2022 May 11. Epub 2022 May 11.

Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, United States.

Posttraumatic enophthalmos (PE) arises when the ocular globe is displaced posteriorly and inferiorly in the orbital cavity due to a mismatch in orbital volume and orbital content. This most commonly happens after orbital fractures. The resulting disruptions to aesthetic form and ocular functions often necessitate surgical correction for reconstruction and restoration. Read More

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Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis.

Clin Ophthalmol 2022 2;16:1365-1373. Epub 2022 May 2.

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Purpose: To describe ophthalmology resident experience with ophthalmic trauma cases in the U.S. . Read More

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South Texas orbital fracture protocol for emergency department evaluation of orbital fractures.

Am J Emerg Med 2022 Apr 27;57:42-46. Epub 2022 Apr 27.

Brooke Army Medical Center, 3551 Roger Brooke Dr., Fort Sam Houston, TX 78234, USA.

Purpose: Facial trauma and orbital fractures are common reasons for ophthalmology consultation in the emergency department (ED). The purpose of this study is to assess intervention rates and evaluate the acuity of ophthalmology consultation for orbital fractures in the ED.

Basic Procedures: A retrospective chart review of orbital fractures was conducted over a 23-month period. Read More

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Globe Fixation Caused by Intraocular Migration of an Orbital Floor Implant.

Ophthalmic Plast Reconstr Surg 2022 May 3. Epub 2022 May 3.

Department of Ophthalmology ZNA Middelheim, Antwerpen, Belgium.

A 30-year-old male presented with diplopia 1 month after implantation of an orbital floor plate for a blowout fracture. The orbital plate was removed 3 months later, however, the fixation bar was left in place as it had migrated full thickness through the inferior oblique muscle, sclera, choroid, and retina. After 5 years of head tilt, the patient was referred to our department with a metallic intra-ocular foreign body visible in fundo and an important elevation deficit. Read More

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Results of a Clinical Scoring System Regarding Symptoms and Surgical Treatment of Isolated Unilateral Zygomatico-Orbital Fractures: A Single-Centre Retrospective Analysis of 461 Cases.

J Clin Med 2022 Apr 14;11(8). Epub 2022 Apr 14.

Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany.

Systematic assessment of computed tomography (CT) scans and clinical symptoms is necessary to quickly indicate the correct treatment of zygomatico-orbital (ZMO) fractures. For this purpose, a clinical scoring system (=Clinical Score) was developed and correlated with CT scans to analyse its validity. Every operated, isolated, and unilateral ZMO fracture between January 2012 and December 2016 was screened retrospectively, including patient and treatment data. Read More

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Ramal bone graft for management of infra-orbital rim fractures with defects - Technical note and a series of 16 cases.

J Stomatol Oral Maxillofac Surg 2022 Apr 20. Epub 2022 Apr 20.

Oculoplasty and Orbital Surgery, Shankara Nethralaya, Chennai 600006, India.

The purpose is to describe a technique of using ramal bone graft for reconstructing defects of the infra-orbital rim (IOR), assess outcomes and complications. This was a retrospective chart review of 16 patients who underwent ramal bone grafting for IOR fractures. Outcomes evaluated were improvement in clinical findings (lid/globe malposition, tethering of facial skin and implant extrusion) and complications. Read More

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Orbital Fractures With Concomitant Ocular Nerve Palsy: An Insidious and Potentially Misleading Association in Surgical Decision-Making.

J Oral Maxillofac Surg 2022 Mar 25. Epub 2022 Mar 25.

Head, Neuro-Ophthalmology and Strabology Unit, Department of Clinical Neurosciences, Division of Ophthalmology, University Hospital and Faculty of Medicine of Geneva, Genève, Switzerland.

Purpose: Orbital fractures (OFs) are common, but their association with concomitant traumatic ocular nerve palsy (TONP) is exceptional and may potentially cause confusing clinical pictures of oculomotor involvement. The purpose of the present study is to describe a series of patients with OFs and concomitant TONP following facial trauma and to evaluate clinical features, diagnostic pitfalls, and final functional outcome.

Methods: The investigators designed and implemented a retrospective case series and enrolled a sample of patients with OFs and concomitant TONP who had been managed at the University Hospitals of Geneva between 2013 and 2020. Read More

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A new approach to categorization of ocular injury among U.S. Armed Forces.

MSMR 2022 02;29(2):8-14

This report describes a new approach to categorizing ocular injury using Military Health System data, the application of an algorithm to a dataset, and the verification of the results using an audit of clinical data. Based on health care encounter data, an algorithm was developed to systematically document the occurrence of specific complications and medical procedures in the 12 months following initial ocular injuries. The injuries were classified into 1 of 2 groups: "uncomplicated injury" with no complications or medical procedures and "complicated injury" with complications and/or medical procedures. Read More

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February 2022

White-eyed blowout fracture, child in danger: A case report.

Malays Fam Physician 2022 Mar 25;17(1):78-81. Epub 2022 Jan 25.

M.D (USM), M.Surg (Ophthal)(UKM) FADUSM, Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia, Email:

A white-eyed blowout fracture is an orbital floor fracture associated with restriction of ocular motility (suggestive of orbital content entrapment) but with minimal or absence of signs of soft tissue trauma. It can lead to significant patient morbidity. This case involved an 8-year-old boy with a white-eyed blowout fracture following facial trauma. Read More

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Sports-related ocular injuries at a tertiary eye hospital in Australia: A 5-year retrospective descriptive study.

Emerg Med Australas 2022 Apr 18. Epub 2022 Apr 18.

Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, The University of Melbourne, Melbourne, Victoria, Australia.

Objective: To describe the demographics and outcomes of sports-related ocular injuries in an Australian tertiary eye hospital setting.

Methods: Retrospective descriptive study from the Royal Victorian Eye and Ear Hospital from 2015 to 2020. Patient demographics, diagnosis and injury causation were recorded from baseline and follow-up. Read More

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Bimodal Approach: A Key to Manage a Case of Traumatic Superior Orbital Fissure Syndrome.

J Emerg Trauma Shock 2022 Jan-Mar;15(1):63-65. Epub 2022 Apr 4.

Department of Oral and Maxillofacial Surgery, D. Y. Patil University School of Dentistry, Navi Mumbai, Maharashtra, India.

An unusual complication associated with maxillofacial trauma is the superior orbital fissure syndrome (SOFS). Trauma-related SOFS often presents within 48 h of injury, but presentation can be delayed by several days. This article sums up the particulars of the syndrome and treatments done in the literature and discusses our experience of managing this complex case. Read More

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A clinical decision aid for patients with suspected midfacial and mandibular fractures (the REDUCTION-I study): a prospective multicentre cohort study.

Eur J Trauma Emerg Surg 2022 Apr 16. Epub 2022 Apr 16.

Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.

Purpose: To assess physical examination findings related to maxillofacial trauma to identify patients at risk of midfacial and mandibular fractures and then to construct a clinical decision aid to rule out the presence of midfacial and mandibular fractures in emergency department patients.

Methods: We performed a prospective multicentre cohort study in four hospitals in the Netherlands, including consecutive patients with maxillofacial trauma. Each patient received a standardized physical examination consisting of 15 and 14 findings for midfacial and mandibular traumas, respectively. Read More

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Prognosticators of Visual Acuity After Indirect Traumatic Optic Neuropathy.

J Neuroophthalmol 2022 Jun 25;42(2):203-207. Epub 2022 Mar 25.

Ruiz Department of Ophthalmology and Visual Science (AJW, JHQ, AZC, OOA), McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, Texas; Robert Cizik Eye Clinic (AJW, JHQ, OOA), Houston, Texas; Lyndon B. Johnson Hospital (AJW, JHQ, OOA), Harris Health, Houston, Texas; Department of Diagnostic & Interventional Imaging McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth) (EPS), Houston, Texas; Departments of Ophthalmology and Neurology (JJC), Mayo Clinic, Rochester, Minnesota; Cullen Eye Institute (RF), Department of Ophthalmology, Baylor College of Medicine, Houston Texas; and Department of Neurology (OOA), McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, Texas.

Background: The purpose of this study is to determine whether there are radiographic and systemic clinical characteristics that can predict final visual outcomes in patients with indirect traumatic optic neuropathy (iTON).

Methods: This study is a retrospective, multicenter case series of adult patients with iTON treated initially at large, urban, and/or academic trauma centers with follow-up at an affiliated ophthalmology clinic. In addition to detailed cranial computed tomography characteristics, demographics, systemic comorbidities, coinjuries, blood products administered, and intracranial pressure, along with other factors, were gathered. Read More

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[Skull and skull base injuries in children and adolescents : Results of a monocentric analysis].

HNO 2022 May 14;70(5):352-360. Epub 2022 Apr 14.

Klinik für Hals‑, Nasen‑, Ohrenheilkunde, KRH Klinikum Nordstadt, Haltenhoffstraße 41, 30167, Hannover, Deutschland.

Background: The present study comprises a retrospective analysis of skull, skull base, and midface fractures in children, to provide clinical orientation for their management. To date, only few data are available on these injuries in this patient group.

Methods: Data from inpatient cases diagnosed with a midface, skull, or skull base fracture in the Children's Hospital Auf der Bult from 2015 to 2020 were evaluated. Read More

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Does Early Treatment of Paediatric Orbital Fracture Offer Any Advantage in Terms of Post-Operative Clinical Outcomes.

J Maxillofac Oral Surg 2022 Mar 11;21(1):25-33. Epub 2021 Mar 11.

Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005 India.

Background: Trapdoor fractures commonly occur in children below 6 years of age. The high resiliency of bone, pneumatisation of sinuses and other factors lead to entrapment of muscle and/or soft tissue which undergoes ischaemic changes leading to residual diplopia. The timing of intervention in children ranges from 24 h to greater than 2 weeks. Read More

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Orbital fractures.

Tidsskr Nor Laegeforen 2022 04 4;142(6). Epub 2022 Apr 4.

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Recurrent Retrobulbar Hemorrhage Associated With CPAP Use After Orbital Fracture Repair.

Ophthalmic Plast Reconstr Surg 2022 Mar 30. Epub 2022 Mar 30.

Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.; and.

We present a patient who underwent orbital fracture repair complicated by retrobulbar hemorrhages twice within the first postoperative week. The suspected cause is continuous positive airway pressure (CPAP) use with inappropriate patient-modified settings. The most likely mechanism of action was venous congestion from the extrinsic positive pressure, similar to Valsalva maneuvers increasing orbital vasculature pressure. Read More

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Mathematical analysis of fracture configuration in predicting outcome in complex anterior skull base trauma.

Br J Oral Maxillofac Surg 2021 Nov 16. Epub 2021 Nov 16.

Department of Anaesthesia, St Marys Hospital NHS Trust, UK.

Craniofacial trauma involving the anterior skull base produces a heterogenous injury with variance in fracture pattern, complexity and outcome. Variance is influenced by the biomechanical properties of the craniofacial construct and by the magnitude and vector of the impacting energy. Fractal dimension and other metrics applied to individual fracture patterns allows quantification of fracture complexity and severity, which can be used to correlate with neurological outcome. Read More

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November 2021

Biocompatible Materials for Orbital Wall Reconstruction-An Overview.

Materials (Basel) 2022 Mar 16;15(6). Epub 2022 Mar 16.

Department of Ophthalmology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, District 5, 020021 Bucharest, Romania.

The reconstruction of an orbit after complex craniofacial fractures can be extremely demanding. For satisfactory functional and aesthetic results, it is necessary to restore the orbital walls and the craniofacial skeleton using various types of materials. The reconstruction materials can be divided into autografts (bone or cartilage tissue) or allografts (metals, ceramics, or plastic materials, and combinations of these materials). Read More

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Outcome Analysis of Surgical Timing in Pediatric Orbital Trapdoor Fracture with Different Entrapment Contents: A Retrospective Study.

Children (Basel) 2022 Mar 11;9(3). Epub 2022 Mar 11.

Division of Traumatic Plastic Surgery, Department of Plastic and Reconstructive Surgery, Craniofacial Research Center, Chang Gung Memorial Hospital at LinKou, Chang Gung University College of Medicine, Taoyuan City 333, Taiwan.

Orbital trapdoor fracture occurs more commonly in pediatric patients, and previous studies suggested early intervention for a better outcome. However, there is no consensus on the appropriate timing of emergent intervention due to the insufficient cases reported. In the current retrospective study, we compared the outcomes of patient groups with different time intervals from injury to surgical intervention and entrapment content. Read More

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Does Intraoperative Navigation Improve Implant Position Accuracy in Orbital Fracture Repair?

Facial Plast Surg Aesthet Med 2022 Mar 21. Epub 2022 Mar 21.

Department of Orbit and Oculoplasty, Shankara Nethralaya, Chennai, Tamil Nadu, India.

Our aim was to determine if intraoperative navigation (ION) improved radiographic outcomes in patients undergoing delayed primary/secondary orbital reconstruction for inferomedial defects, as measured by volume restoration, enophthalmos correction, and positional accuracy of implants. A prospective quasiexperimental study was performed to compare two groups of patients requiring orbital reconstruction. Use of ION was the exposure evaluated. Read More

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