Diagnosis and treatment of fractures of the orbital floor. A ten-year retrospective study.

In a retrospective study of 42 patients treated for fractures of the orbital floor at Södersjukhuset, different diagnostic methods and the final outcome of the treatment were evaluated. Motility evaluation and exphtalmometry were performed on all patients by the same ophtalmologist. Twenty patients underwent computed tomography with coronal scans. The prolapse and volume of the herniated soft tissue from the orbit and the degree of entrapment of the inferior rectus muscle were measured from the CT scans. All patients who developed enophtalmos had according to the CT scans herniated volumes exceeding 0.7 ml. Only 2 out of 9 patients, who did not develop enophtalmos had herniated volumes exceeding 0.7 ml. This difference was statistically significant. Of these patients 36 were operated, while 6 patients were only followed. The mean follow-up time was 6 months. Out of 39 patients followed for more than 3 months, 28 were symptom free. Six patients were moderately molested by diplopia or enophtalmos. Five patients suffered from a persistent clinically significant diplopia or enophtalmos.