Orbital floor fracture with entrapment: Imaging and clinical correlations in 45 cases

Nora Silverman, Jordan Spindle, Sunny X. Tang, Andrew Wu, Bryan K. Hong, John W. Shore, Sara Wester, Flora Levin, Michael Connor, Benjamin Burt, Tanuj Nakra, Todd Shepler, Eric Hink, Tarek El-Sawy, Roman Shinder

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Orbital floor fractures (OFF) with entrapment require prompt clinical and radiographic recognition for timely surgical correction. Correct CT radiographic interpretation of entrapped fractures can be subtle and thus missed. We reviewed the clinical, radiographic and intraoperative findings of 45 cases of entrapped OFF to correlate pre- and intraoperative findings with radiography. Retrospective review and statistical analysis of 45 patients with OFF using the chi squared and Kruskal–Wallis tests. Main outcome measures included patient demographics, clinical features, radiologic interpretation, intraoperative findings, and treatment outcomes. Twenty-one cases (47%) had radiologic evaluations of orbital CT scans that included commentary on possible entrapment. Intraoperatively, 16 (76%) of these patients had the inferior rectus muscle incarcerated in the fracture, while 5 (24%) patients had incarceration of the orbital fat. Possibility of entrapment was not commented on in the radiology reports of the remaining 24 (53%) cases. Intraoperatively, 13 (54%) of these patients had the inferior rectus muscle incarcerated in the fracture, while 11 (46%) patients had incarceration of the orbital fat. It is vital to assess the possibility of entrapment, especially in young patients, in the setting of OFF as a delay in diagnosis may lead to persistent diplopia, disfigurement, or bradycardia. Most radiology reports did not mention the possibility of entrapment in this cohort. A key concept is that entrapment occurs when any orbital tissue (muscle or fat) is trapped in the fracture site.

Original languageEnglish (US)
Pages (from-to)331-336
Number of pages6
JournalOrbit
Volume36
Issue number5
DOIs
StatePublished - Sep 3 2017

Fingerprint

Orbital Fractures
Fats
Radiology
Muscles
Diplopia
Bradycardia
Radiography
Demography
Outcome Assessment (Health Care)

Keywords

  • entrapment
  • fracture
  • Orbital floor fracture
  • trauma

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Silverman, N., Spindle, J., Tang, S. X., Wu, A., Hong, B. K., Shore, J. W., ... Shinder, R. (2017). Orbital floor fracture with entrapment: Imaging and clinical correlations in 45 cases. Orbit, 36(5), 331-336. https://doi.org/10.1080/01676830.2017.1337180

Orbital floor fracture with entrapment : Imaging and clinical correlations in 45 cases. / Silverman, Nora; Spindle, Jordan; Tang, Sunny X.; Wu, Andrew; Hong, Bryan K.; Shore, John W.; Wester, Sara; Levin, Flora; Connor, Michael; Burt, Benjamin; Nakra, Tanuj; Shepler, Todd; Hink, Eric; El-Sawy, Tarek; Shinder, Roman.

In: Orbit, Vol. 36, No. 5, 03.09.2017, p. 331-336.

Research output: Contribution to journalArticle

Silverman, N, Spindle, J, Tang, SX, Wu, A, Hong, BK, Shore, JW, Wester, S, Levin, F, Connor, M, Burt, B, Nakra, T, Shepler, T, Hink, E, El-Sawy, T & Shinder, R 2017, 'Orbital floor fracture with entrapment: Imaging and clinical correlations in 45 cases', Orbit, vol. 36, no. 5, pp. 331-336. https://doi.org/10.1080/01676830.2017.1337180
Silverman N, Spindle J, Tang SX, Wu A, Hong BK, Shore JW et al. Orbital floor fracture with entrapment: Imaging and clinical correlations in 45 cases. Orbit. 2017 Sep 3;36(5):331-336. https://doi.org/10.1080/01676830.2017.1337180
Silverman, Nora ; Spindle, Jordan ; Tang, Sunny X. ; Wu, Andrew ; Hong, Bryan K. ; Shore, John W. ; Wester, Sara ; Levin, Flora ; Connor, Michael ; Burt, Benjamin ; Nakra, Tanuj ; Shepler, Todd ; Hink, Eric ; El-Sawy, Tarek ; Shinder, Roman. / Orbital floor fracture with entrapment : Imaging and clinical correlations in 45 cases. In: Orbit. 2017 ; Vol. 36, No. 5. pp. 331-336.
@article{80e8ed0c2cba48d99f5871f0575046e1,
title = "Orbital floor fracture with entrapment: Imaging and clinical correlations in 45 cases",
abstract = "Orbital floor fractures (OFF) with entrapment require prompt clinical and radiographic recognition for timely surgical correction. Correct CT radiographic interpretation of entrapped fractures can be subtle and thus missed. We reviewed the clinical, radiographic and intraoperative findings of 45 cases of entrapped OFF to correlate pre- and intraoperative findings with radiography. Retrospective review and statistical analysis of 45 patients with OFF using the chi squared and Kruskal–Wallis tests. Main outcome measures included patient demographics, clinical features, radiologic interpretation, intraoperative findings, and treatment outcomes. Twenty-one cases (47{\%}) had radiologic evaluations of orbital CT scans that included commentary on possible entrapment. Intraoperatively, 16 (76{\%}) of these patients had the inferior rectus muscle incarcerated in the fracture, while 5 (24{\%}) patients had incarceration of the orbital fat. Possibility of entrapment was not commented on in the radiology reports of the remaining 24 (53{\%}) cases. Intraoperatively, 13 (54{\%}) of these patients had the inferior rectus muscle incarcerated in the fracture, while 11 (46{\%}) patients had incarceration of the orbital fat. It is vital to assess the possibility of entrapment, especially in young patients, in the setting of OFF as a delay in diagnosis may lead to persistent diplopia, disfigurement, or bradycardia. Most radiology reports did not mention the possibility of entrapment in this cohort. A key concept is that entrapment occurs when any orbital tissue (muscle or fat) is trapped in the fracture site.",
keywords = "entrapment, fracture, Orbital floor fracture, trauma",
author = "Nora Silverman and Jordan Spindle and Tang, {Sunny X.} and Andrew Wu and Hong, {Bryan K.} and Shore, {John W.} and Sara Wester and Flora Levin and Michael Connor and Benjamin Burt and Tanuj Nakra and Todd Shepler and Eric Hink and Tarek El-Sawy and Roman Shinder",
year = "2017",
month = "9",
day = "3",
doi = "10.1080/01676830.2017.1337180",
language = "English (US)",
volume = "36",
pages = "331--336",
journal = "Orbit",
issn = "0167-6830",
publisher = "Informa Healthcare",
number = "5",

}

TY - JOUR

T1 - Orbital floor fracture with entrapment

T2 - Imaging and clinical correlations in 45 cases

AU - Silverman, Nora

AU - Spindle, Jordan

AU - Tang, Sunny X.

AU - Wu, Andrew

AU - Hong, Bryan K.

AU - Shore, John W.

AU - Wester, Sara

AU - Levin, Flora

AU - Connor, Michael

AU - Burt, Benjamin

AU - Nakra, Tanuj

AU - Shepler, Todd

AU - Hink, Eric

AU - El-Sawy, Tarek

AU - Shinder, Roman

PY - 2017/9/3

Y1 - 2017/9/3

N2 - Orbital floor fractures (OFF) with entrapment require prompt clinical and radiographic recognition for timely surgical correction. Correct CT radiographic interpretation of entrapped fractures can be subtle and thus missed. We reviewed the clinical, radiographic and intraoperative findings of 45 cases of entrapped OFF to correlate pre- and intraoperative findings with radiography. Retrospective review and statistical analysis of 45 patients with OFF using the chi squared and Kruskal–Wallis tests. Main outcome measures included patient demographics, clinical features, radiologic interpretation, intraoperative findings, and treatment outcomes. Twenty-one cases (47%) had radiologic evaluations of orbital CT scans that included commentary on possible entrapment. Intraoperatively, 16 (76%) of these patients had the inferior rectus muscle incarcerated in the fracture, while 5 (24%) patients had incarceration of the orbital fat. Possibility of entrapment was not commented on in the radiology reports of the remaining 24 (53%) cases. Intraoperatively, 13 (54%) of these patients had the inferior rectus muscle incarcerated in the fracture, while 11 (46%) patients had incarceration of the orbital fat. It is vital to assess the possibility of entrapment, especially in young patients, in the setting of OFF as a delay in diagnosis may lead to persistent diplopia, disfigurement, or bradycardia. Most radiology reports did not mention the possibility of entrapment in this cohort. A key concept is that entrapment occurs when any orbital tissue (muscle or fat) is trapped in the fracture site.

AB - Orbital floor fractures (OFF) with entrapment require prompt clinical and radiographic recognition for timely surgical correction. Correct CT radiographic interpretation of entrapped fractures can be subtle and thus missed. We reviewed the clinical, radiographic and intraoperative findings of 45 cases of entrapped OFF to correlate pre- and intraoperative findings with radiography. Retrospective review and statistical analysis of 45 patients with OFF using the chi squared and Kruskal–Wallis tests. Main outcome measures included patient demographics, clinical features, radiologic interpretation, intraoperative findings, and treatment outcomes. Twenty-one cases (47%) had radiologic evaluations of orbital CT scans that included commentary on possible entrapment. Intraoperatively, 16 (76%) of these patients had the inferior rectus muscle incarcerated in the fracture, while 5 (24%) patients had incarceration of the orbital fat. Possibility of entrapment was not commented on in the radiology reports of the remaining 24 (53%) cases. Intraoperatively, 13 (54%) of these patients had the inferior rectus muscle incarcerated in the fracture, while 11 (46%) patients had incarceration of the orbital fat. It is vital to assess the possibility of entrapment, especially in young patients, in the setting of OFF as a delay in diagnosis may lead to persistent diplopia, disfigurement, or bradycardia. Most radiology reports did not mention the possibility of entrapment in this cohort. A key concept is that entrapment occurs when any orbital tissue (muscle or fat) is trapped in the fracture site.

KW - entrapment

KW - fracture

KW - Orbital floor fracture

KW - trauma

UR - http://www.scopus.com/inward/record.url?scp=85023760899&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85023760899&partnerID=8YFLogxK

U2 - 10.1080/01676830.2017.1337180

DO - 10.1080/01676830.2017.1337180

M3 - Article

C2 - 28704114

AN - SCOPUS:85023760899

VL - 36

SP - 331

EP - 336

JO - Orbit

JF - Orbit

SN - 0167-6830

IS - 5

ER -