Optimal Management of Orbital Blowout Fracture with Limited Available Resources: A 5 Years’ Experience from Nepal
Abstract
Background: Reconstruction of orbital wall fracture is not only difficult but challenging for restoring orbital cavity volume and shape. This study aimed to evaluate the outcome of orbital wall fracture reconstructed with limited available resources. Method -A single-center, retrospective analysis of orbital wall fracture reconstructed with silastic sheets from January 2015 to December 2019 was conducted after ethical approval from the institutional review committee. Electronic medical records (EMR) of post-operative cases were thoroughly reviewed and data based on demographic profile, nature of trauma, site of the fracture, surgical complication, and outcome were entered into Microsoft Excel and analyzed using Statistical Package for Social Sciences version 20(SPSS). Result-A total of 33 blow-out fractures, 15(45.5%) right eye and 18(54.5%) left eye, reconstructed with silastic sheets were included. Of the total, 23(69.7%) were male. The mean age of patients was 27.79 ± 11.56years (range, 6- 50). The common mode of injury was physical assault 11(33.3%) followed by fall injury 10(30.3%) and road traffic accidents (RTAs) 5(15.2%). An isolated floor fracture was found in 21 (63.6%) cases. The mean duration from injury to surgery was 113.97± 385 days. The mean reduction of enophthalmos and hypoglobus was 1.7±0.6 mm and 1.4±1.2mm respectively. The diplopia, enophthalmos, hypoglobus, and hypoesthesia completely resolved in 88.9%, 92.3%, 100%, and 88.9% cases respectively. Two patients reported implant extrusion. Conclusion-Physical assault, falling injury, and road traffic accidents were common causes of fracture. Overall surgical outcome was good with the silastic implants. However, public awareness against violence, RTAs, and a safe working environment is indispensable for preventing fracture.