Is left eye orbit fracture swollen now?

summary

Applied anatomy and injury characteristics of the orbit: the orbit is a bony scaffold between the skull and the facial bone. It is conical in shape, with the top of the orbital apex and the optic nerve passing through. The base is orbital margin, including supraorbital margin, infraorbital margin, intraorbital margin and extraorbital margin. Let's share my experience with you.

Is left eye orbit fracture swollen now?

1. Periorbital lenticular congestion due to periorbital soft tissue loose, rich blood vessels, orbital fractures will cause different degrees of adjacent soft tissue contusion. Blepharon, conjunctiva and its surrounding soft tissue bleeding, in conjunctiva, orbital congestion spot, the patient seems to wear a pair of dark glasses, so it is called "spectacle sign".

2. Diplopia diplopia is the most common symptom of orbital fracture, especially orbital floor fracture. There are four reasons for diplopia caused by orbital fracture: (1) direct injury of eye movement muscle in orbital fracture; ② Bone fragments damage the nerves that control the ophthalmic muscles, such as the orbital wall fracture, it is easy to damage the oculomotor nerve and cause the movement disorder of the superior ophthalmic muscle; ③ The orbital wall fracture was displaced and the soft tissue was embedded in the fracture line. Especially for orbital floor comminuted fracture, the orbital floor support function is lost, and the orbital contents are embedded in the maxillary sinus, which often causes the movement disorder of rectus and oblique muscles, and limits the upward movement of the eyeball; ④ The contents of the orbit fall into the maxillary sinus, the suspensory ligament of the eyeball moves down, and the eyeball moves down, so that the bilateral eyeballs are not at the same level, resulting in diplopia.

3. Enophthalmos is one of the main manifestations of orbital floor comminuted fracture. The most common causes of enophthalmos immediately after injury are: (1) orbital floor rupture and orbital fat sinking into maxillary sinus; ② The fracture was displaced and the orbital cavity was enlarged. The original orbital fat is not enough to pad the eyeball. The progressive enophthalmos after injury may be caused by delayed reduction of ocular muscle impaction, shortening after muscle fibrosis, or orbital hematoma or mild infection, and gradual necrosis of orbital fat. If hematoma is formed by orbital hemorrhage after injury, it may not appear enophthalmos, but exophthalmos.

matters needing attention

The earlier the better: in the initial debridement suture or open reduction at the same time, the orbital content reduction and orbital wall repair, can avoid the later soft tissue edema caused by incarceration of soft tissue reduction difficulties. If the soft tissue is obviously swollen after injury, the operation can be postponed. One week later, the swelling was relieved and the operation should be performed as soon as possible. The operation must be completed in the second to third week. Otherwise. Long term incarceration of soft tissue, muscle fibrosis, scarring of soft tissue. Even after reset, it can not perform normal function.