J Korean Soc Emerg Med.  2017 Dec;28(6):595-601. 10.0000/jksem.2017.28.6.595.

Prediction of the Likelihood of Surgical Management in Blow-out Fracture Patients: Using Two CT Measuring Method, DFD and CCD

• Kwak SH
• Choi HS
• Lee JS
• Jeong KY
• Hong HP
• Ko YG

• KMID: 2403278
• DOI: http://doi.org/10.0000/jksem.2017.28.6.595

Abstract

PURPOSE
The purpose of this study was to evaluate the predictive value of the measured factors that can be used in an emergency department to assess patients with blow-out fractures (BOFs) who are expected to undergo surgical management.
METHODS
This study was conducted on patients with BOFs who attended an emergency department in a tertiary teaching hospital from December 2013 to November 2016. The medical records and radiology findings, such as facial computed tomography (CT), were reviewed retrospectively. The depth of floor displacement (DFD) and cranial-caudal dimension (CCD), which were measured using facial CT, were evaluated to determine the power of the CT parameters as predictors expecting surgical management in BOF patients. Statistical analysis was conducted with SPSS statistics ver. 23.0.
RESULTS
The final 44 BOF patients were included in the study. Among them, 21 patients had undergone surgery. From this study, using a threshold DFD value of 0.5 cm, the accuracy of DFD was 86.36%, and the sensitivity and specificity in predicting surgery in BOF patients was 100% and 73.91%, respectively. Using a threshold CCD value of 0.4 cm, the accuracy of CCD was 88.64%, and the sensitivity and specificity in predicting surgery in BOF patients was 100% and 78.26%, respectively.
CONCLUSION
With the aid of DFD and CCD, which was measured from facial CT, BOF patients who may require surgical management can be detected easily and more promptly by emergency physicians in emergency settings.

Keyword

Orbital fractures; Prognosis; Emergency medicine; Hospitals

MeSH Terms

Emergencies
Emergency Medicine
Emergency Service, Hospital
Hospitals, Teaching
Humans
Medical Records
Methods*
Orbital Fractures*
Prognosis
Retrospective Studies
Sensitivity and Specificity