Page 111 - Advanced concepts in orbital wall fractures

first presentation (one patient) and after 2 weeks (one patient), motility disturbance combined with enophthalmos at first presentation (one patient), unimproved motility after 2 weeks (eight patients), and persistent pain and diplopia after 3 months (one patient). Neither location (p=1.00) nor severity of the fracture (p=0.052) were significantly different between the surgical and nonsurgical group.
Table 2 Patient characteristics.
Clinical perspective
Age (mean, range) Gender
Aetiology
Affected side Treatment Location
Severity
49 years,
Male Female
Violence Fall Traffic Sports Work
Left Right
Nonsurgical Surgical
Floor Medial Both
I II III IV
20-85 years
33 (57 %) 25 (43 %)
22 (38 %) 17 (29 %) 9 (16 %) 8 (14 %) 2 (3 %)
36 (62 %) 22 (38 %)
46 (79 %) 12 (21 %)
Nonsurgical 31 (67 %)
5 (11 %)
10 (22 %)
Nonsurgical 11 (24 %) 26 (57 %)
8 (17 %)
1 (2 %)
Surgical 8 (67 %) 1 (8 %) 3 (25 %)
Surgical 0 (0 %) 7 (58 %) 3 (25 %) 2 (17 %)
(p=1.00) C
6
(p=0.052)
General outcome at the end of follow-up
In the nonsurgical group 32 patients had an excellent outcome, with nine classed as good and five as acceptable. In the surgical group two patients had an excellent outcome, two good, two acceptable and six poor (Table 3). Differences in outcome were mainly caused by persistent diplopia and other complications or sequelae.
Diplopia was observed in five nonsurgical patients in extreme upward gaze (score 1). Mean binocular single vision (BSV) score for the nonsurgical group was 99.2 (SD 2.5) and mean quality-of-life (QoL) score was 99.0 (SD 4.3). Mean BSV and QoL scores for the five patients with diplopia in
109