Clinical Analysis of Blow-out Fracture with Ocualr Motion Limitation: Comparison of Surgical and Conservative Treatment

Kim, Hyun Woong; Kim, Young Il; Won, In Kun

Abstract

If surgical treatment is not given to the blow-out frature at proper time after trama, diplopia due to motion limitation of globe and poor cosmesis by progressing enophthalmos may troubles in everyday life. But in spite of large fracture andsevere diplopia, these symptoms may be improved with only conservative treatment. From January 1990 to June 1997 authors reviewed 192 consecutive patients with orbital wall fracture. 1997 authors reviewed 192 consecutive patients woth orbital wall frature. Among them, 123 patients who treated with conservative method and 69 patients with surgery. Both conservative treatment group and surgical group had similar demographics in sex, age, cause of trauma, associated symptoms and location of orbital wall fracture. But incidence of extraocular muscle entrapment was more common in surgical treatment group than conservative at 2 months after trauma. In principle blow-out fracture should be repaired surgically for maintenance of normal orbital wall stracture. In addition to improvement of diplopia that can be achieved by conservative treatment, there are many complications such as anesthetic accident, persistant diplopia poeroperatively and scar formation in lower lid associated with surgical treatment of blow-out fracture. Therefore, restrictive application of surgical indication shoul be considered.