A Clinical Study Of Ethmo-maxillary Bone Buttress Fractures In Pure Orbital Fractures

Objective:The purpose of this study was to observe the clinical characteristics and surgical repair techniques of ethmo-maxillary bone buttress fractures in pure orbital fractures,so as to provide some clinical references.Methods:A total of 121 patients(121 eyes)with pure orbital fractures,who underwent orbital wall fracture repair and orbital bone defect repair in our hospital from 2015 to 2020 were selected.According to the preoperative CT examination,the orbital wall fracture types were divided into 4 groups: Group I: 31 cases(31 eyes)of the medial wall fractured;Group II: 39 cases(39 eyes)of the inferior wall fractured;Group III: 27 cases(27 eyes)of combined medial and inferior walls fractured without the ethmo-maxillary bone buttress fractured;Group IV: 24 cases(24 eyes)of medial fractured with ethmo-maxillary bone buttress destruction combined with inferior orbital fractured.The diplopia,enophthalmos,operation and implant materials were analyzed and compared before and after operations.Results: There were no statistically significant differences in preoperative enophthalmos between Group I and Group II,Group I and Group III,and Group II and Group III(P>0.05).There were statistically significant differences in preoperative enophthalmos between Group IV and the other three groups(t=2.025,P=0.048;t=2.601,P=0.012;t=2.696,P=0.01).The preoperative diplopia of Group I and Group II was significantly different from that of Group III and Group IV(P<0.05).There was no significant difference in preoperative diplopia between Group I and Group II,Group III and Group IV.There were no significant differences in enophthalmos and diplopia between the four groups after operations(P>0.05).Postoperative diplopia in four groups was statistically significant compared with that before surgery,so as to enophthalmos(P<0.05).There was no statistically significant difference in the number of Medpor and PLLA used among the four groups.There were no statistically significant differences in the amount of postoperative enophthalmos and diplopia after using two implant materials in each group(P>0.05).Conclusions:1.Pure orbital fractures involving the ethmo-maxillary bone buttress collapse were more severe in exophthalmos patients than those with orbital fractures not involving the struct;2.Compared with a single orbital fracture,patients with pure orbital fracture with or without the ethmo-maxillary bone buttress involvement were more likely to have diplopia in patients with both medial and inferior walls fracture;3.Operation can correct diplopia and enophthalmos in patients with ethmo-maxillary bone buttress fractures in pure orbital fractures.Medpor and PLLA have no significant difference in the correction of diplopia and enophthalmos,which are safe and effective.