Isolated Orbital Fractures Are Severe Among Geriatric Patients

Publication date: Available online 9 October 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Miika Toivari Resident, Anna Liisa Suominen, Satu Apajalahti, Christian Lindqvist, Johanna Snäll, Hanna Thorén
PurposeThe purpose of the study was to clarify the reasons for, the types and degree of involvement of the orbital wall, and the severity of orbital fractures in geriatric patients and to compare the differences between geriatric and younger adult patients.Materials and methodsA retrospective case-control study on geriatric patients aged at least 65 years (n=72) and younger controls aged 20–50 years (n=58), diagnosed with unilateral isolated orbital fractures, was designed and implemented. The main exposure was age, the primary outcome was the type of isolated orbital fracture, and secondary outcomes were the associated orbital zones, fracture area (cm²), degree of dislocation (mm), involvement of anatomical landmarks, diplopia, altered ocular position, restricted eye movement, and ocular injuries. The confounding variables were gender, trauma mechanism, and abuse of alcohol. Statistical methods included χ² tests and logistic regression analyses.ResultsAmong the geriatric patients, the great majority of isolated orbital fractures were caused by falls (66.7%) (P < .001). Geriatric orbital fractures were significantly more often extensive [≥2 cm²] (P = .045) and associated with the middle-posterior orbital third (P = .032). In logistic regression analyses, the elderly had a 2.2-fold higher risk of fractures of the middle-posterior orbital third and a 2.3-fold higher risk of extensive fractures compared to the younger controls. Ocular injuries were only diagnosed in the geriatric patients (5.6%).ConclusionFalling is the most common mechanism for elderly orbital fractures. Isolated orbital fractures are extensive, and mainly affect the globe supporting the middle and posterior parts of the orbital floor among geriatric patients.



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