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Ham, Lee, and Yang: A Study of Different Aspects of Blowout Fracture Between Preoperative CT and Intraoperative Images
Original Article

J Korean Ophthalmol Soc 2011;52(8):902-909.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.8.902

A Study of Different Aspects of Blowout Fracture Between Preoperative CT and Intraoperative Images

Dong Sik Ham, MD1, Chung Hyun Lee, MD2, Jae Wook Yang, MD, PhD1

1Department of Ophthalmology, Inje University Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea

2Department of Ophthalmology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Asan, Korea

Address reprint requests to Jae Wook Yang, MD, PhD Department of Ophthalmology, Inje University Pusan Paik Hospital #633-165 Gaegeum-dong, Busanjin-gu, Busan 614-735, Korea Tel: 82-51-890-6356, Fax: 82-51-890-6329, E-mail: eyeyang@inje.ac.kr

Received 13 December 2010       Revised 15 February 2011       Accepted 6 May 2011

Copyright © 2011 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the morphologic differences in blowout fracture seen on preoperative CT images compared to intraoperative images.

Methods

The present study included 63 patients (63 eyes) with orbital fractures that were repaired by orbital reconstruction between January 2009 and April 2010. We assessed the medial, inferior, and inferomedial orbital fractures and excluded superior and lateral wall fractures. We captured intraoperative blowout fracture images using a camera or endoscope and compared the fracture type (fracture size, fracture surface) seen on intraoperative images with that observed on the pre-operative CT images.

Results

The study consisted of patients between 20 and 50 years of age with a mean age of 27.76 years (men: 49 eyes, women: 14 eyes). The proportions of small fractures and medium fractures were similar on the preoperative CT images; however, large fractures were observed more frequently on the intraoperative images. The proportions of mono-fragment fractures and multi-fragment fractures were similar on the preoperative CT images, but multi-fragment fractures, especially inferior orbital fractures, were more frequent on the intraoperative images. Features of the trapdoor fracture differed most between images in terms of fracture size and surface.

Conclusions

The morphology of blowout fractures, especially trapdoor fractures, differed between preoperative CT images and intraoperative images.

Keywords: Blowout fracture, Computed tomography, Fracture image, Trap door fracture

References

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Figure 1.
The size of the orbital wall fracture (arrow) classified into small (A, D), medium (B, E) and large (C, F, H) at inferior (A, B, C), medial (D, E, F) and inferomedial (G, H) orbital wall fracture.
jkos-52-902f1.tif
Figure 2.
The surface of the orbital wall fracture (arrow) classified into mono-fragment fracture (A, C, E), multi-fragment fracture (B, D, F) at inferior (A, B), medial (C, D) and inferomedial (E, F) orbital wall fracture.
jkos-52-902f2.tif
Figure 3.
Different fracture pattern in preoperative CT image and intraoperative real image. (A) Preop CT image: small, mono-fragment, inferior, trapdoor fracture. (B) Intraop real image: medium, multi-fragment, inferior fracture. (C) Preop CT image: small, inferior, trapdoor fracture. (D) Intraop real image: large, inferior fracture. (E) Preop CT image: large, mono-fragment, inferior fracture. (F) Intraop real image: large, multi-fragment inferior fracture.
jkos-52-902f3.tif
Figure 4.
The different size of orbital wall fracture in preop CT image and intraop real image.
jkos-52-902f4.tif
Figure 5.
The different surface of orbital wall fracture in preop CT image and intraop real image.
jkos-52-902f5.tif
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