Factors Associated with Decision to Operate in Orbital Fractures

Shin, Sun Woo; Jo, Ik Joon; Song, Hyoung Gon; Ghim, Byung Kwon

Abstract

PURPOSE: This study was performed to evaluate factors affecting the decision to operate in orbital fracture patients.
METHODS
This study included 396 orbital fracture patients who visited an urban tertiary teaching hospital emergency room from January 1, 2002 to December 31, 2005. We reviewed medical records of the patients. Data collected included a patient's sex, age, mechanism of trauma, wall fractures, associated other facial bone fracture, visual disturbance and ocular motility disturbance. The Chi-square test, t-test were applied in order to evaluate the factors associated with the decision to operate in orbital fracture cases. Multinomial logistic regression was applied to those factors which achieved significance in Chi-square test.
RESULTS
As seen in other studies, orbital fractures were frequent in young males ages 10 through 40. The most common cause of orbital fractures was violence (41.0%). In the Chi-square test, medial, lateral and inferior wall fractures; skull vault fracture; nasal septum fracture; diplopia; ocular motor dysfunction; and fractures involving more than two walls were found to be statistically significant in the decision to operate compared to other factors. Diplopia, lateral wall fracture, ocular motor dysfunction, skull vault fracture, and inferior wall fracture were confirmed by multinominal logistic regression analysis as positive predictors of a decision to operate in orbital fracture.
CONCLUSION
Orbital wall fracture patient with diplopia, lateral or inferior wall fracture, ocular motor dysfunction, and skull vault fracture are likely to result in surgical intervention.