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Orbital fractures

最后审阅: 19 Aug 2025
最后更新: 01 Apr 2025

小结

定义

病史和体格检查

关键诊断因素

  • diplopia on upward gaze
  • derangement of globe position
  • intercanthal distance increased
  • oculovagal symptoms (bradycardia, hypotension, nausea/vomiting)
完整详情

其他诊断因素

  • visual disturbance
  • periorbital ecchymosis
  • periorbital edema
  • nerve sensory loss
  • subconjunctival hemorrhage
  • step defect infraorbital rim
  • loss of color vision
  • impaired pupillary light reflex
  • decreased visual acuity
完整详情

危险因素

  • direct trauma
  • young adults and children
  • older adults at risk of falls
  • male sex
完整详情

诊断性检查

首要检查

  • x-ray of the face
  • CT scan of the orbit
完整详情

需考虑的检查

  • MRI of the orbit
  • forced duction test
  • orthoptic test
完整详情

新兴检查

  • ultrasonographic orbital scanning

治疗流程

急症处理

urgent eye morbidity

no urgent eye morbidity

撰稿人

作者

Alistair R.M. Cobb, MBBS, BDS, FRCS (OMFS), FDSRCS (Eng), MFSEM (UK)

Consultant Oral and Maxillofacial Surgeon

South West Cleft Service

United Hospitals Bristol NHS Trust

Bristol

UK

利益声明

ARMC is an author of a number of references cited in this topic.

鸣谢

Mr Alistair Cobb would like to gratefully acknowledge Mr Timothy Lloyd, a previous contributor to this topic.

利益声明

TL declares that he has no competing interests.

同行评议者

Andrew Parfitt, MBBS, FFAEM

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

利益声明

AP declares that he has no competing interests.

Mark I. Neuman, MD

Assistant Professor of Pediatrics

Children's Hospital Boston

Harvard Medical School

Boston

MA

利益声明

MIN declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Manolidis S, Weeks BH, Kirby M, et al. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg. 2002 Nov;13(6):726-37. 摘要

Cobb A, Murthy R, Manisali M, et al. Oculovagal reflex in paediatric orbital floor fractures mimicking head injury. Emerg Med J. 2009 May;26(5):351-3. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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