A current 10-year retrospective survey of 199 surgically treated orbital floor fractures in a nonurban tertiary care center

This study characterizes the surgically treated patient population sufferin g from orbital floor fractures by use of current data from a large series c onsisting of 199 cases taken from a nonurban setting. Data were gathered th rough a retrospective chart review of patients surgically treated for orbit al floor fractures at the University of Michigan Health System, collected o ver a 10-year period. Data regarding patient demographics, signs and sympto ms of presentation, cause of injury, nature of injury, associated facial fr actures, ocular injury, and associated nonfacial skeleton trauma were colle cted. In total, there were 199 cases of orbital floor fractures among 189 p atients. Male patients outnumbered female patients by a 2:1 ratio and were found to engage in a wider range of behaviors that resulted in orbital floo r fractures. Motor vehicle accidents were the leading cause of orbital floo r fractures, followed by physical assault and sports-related mechanisms. Th e ratio of impure to pure orbital floor fracture was 3:1 The most common si -ns and symptoms. associated with orbital floor fractures, in descending or der, were periorbital ecchymosis, diplopia, subconjunctival hemorrhage, and enophthalmos. Associated facial fractures were found in 77.2 percent of pa tients, the most prevalent of which was the zygoma-malar fracture. Serious ocular injury occurred in 19.6 percent of patients, with globe rupture bein g the most prevalent, accounting for 40.5 percent of those injuries. There was a 38.1 percent occurrence of associated nonfacial skeletal trauma; skul l fracture and intracranial injury were the most prevalent manifestations. Associated cervical-spine fractures were rare (0.5 percent). Statistical ex amination, using odds ratios and chi-squared analysis, demonstrated signifi cant associations that have not previously been reported. Impure and pure o rbital floor fractures revealed striking differences in several demographic aspects, including mechanism of injury, signs and symptoms of presentation , spectrum of associated trauma, and the severity of concomitant trauma.