Orbital Fractures Treated in a University Hospital of Southern Italy: Epidemiology, Outcomes and Prognostic Factors Resulting From 538 Retrospectively Analyzed Cases.

Abstract

Abstract Purpose: Orbital fractures are common injuries and represent an interesting chapter in maxillofacial surgery. This retrospective study analyses data collected from 528 patients surgically treated at the University Hospital "Magna Graecia", Catanzaro, Italy, from 1st January 2007 to 31st January 2021. Methods: The inclusion criteria were diagnosis of orbital bone fracture, complete clinical and radiological records, and a minimum follow-up of 12 months. Gender, age, aetiology, fracture type, treatment, surgery timing, and associated complications were analysed. Results: The most frequent cause of trauma was road accidents (37.88%), followed by domestic accidents (25.95%). The manifestation of diplopia (72.35%), infraorbital nerve hypoesthesia (53.41%), extrinsic eye movement limitation (51.70%), and enophthalmos (41.29%), determined the indication for surgery. The sub-eyelid approach was preferred (79.36%). The study shows a statistical significance in the correlation between the severity of the herniation of the lower rectus muscle and the presence of preoperative diplopia (p-value = 0.00416); the same statistical significance has been found for the post-postoperative diplopia (p-value = 0.00385). Patients treated after two weeks after the trauma show a higher rate of diplopia and a greater limitation of long-term post-operative eye movements than those treated within two weeks (diplopia 23.08% vs. 15.56%; eye movements limitation 13.33% vs. 7.69%). Early surgical treatment (>14 days) appears to reduce the likelihood of functional and structural damage to the lower rectus muscle. Conclusion: Our data will support future maxillofacial traumatology studies and the education and prevention measures taken will reduce the incidence of orbital trauma.