Fractures about the orbit in professional American football players

A retrospective review was performed of records for players who suffered fr actures about the orbit during participation in officially sponsored activi ties of the National Football League from 1980 to 1997. Clinical informatio n was obtained on 19 of 29 players who sustained orbital fractures. The mos t common signs and symptoms included decreased visual acuity (74%, 14), dec reased eye movement (42%, 8), hyphema (37%, 7), and infraorbital numbness ( 21%, 4). The mechanisms of injury were a digital poke (74%,14) and blunt fa cial trauma (26%, 5). There were significantly more orbital fractures than zygomatic fractures suffered by offensive linemen as compared with all othe r positions. Fifteen of 19 players were managed with surgical reconstructio n; 4 players were treated nonoperatively. The mean time from injury to surg ical procedure was 7.7 days (range, 0 to 42). The mean interval to follow-u p was 45.6 months (range, 3 to 146). At follow-up examination, eight (53%) of the patients treated surgically still reported diplopia with upper field gaze. Three of the four patients treated nonoperatively were asymptomatic. The mean time lost from games or practice was 25 days (range, 5 to 56). Ul timately, 17 (89%) players with orbital fractures were able to return to fu ll football activities. Two patients were unable to resume their careers be cause of residual visual impairment.