吹き抜け骨折
WordNet
- interrupt, break, or destroy; "fracture the balance of power"
- breaking of hard tissue such as bone; "it was a nasty fracture"; "the break seems to have been caused by a fall" (同)break
- fracture a bone of; "I broke my foot while playing hockey" (同)break
- become fractured; "The tibia fractured from the blow of the iron pipe"
- break (a bone); "She broke her clavicle"
- break into pieces; "The pothole fractured a bolt on the axle"
- violate or abuse; "This writer really fractures the language"
- the act of cracking something (同)crack, cracking
- a sudden malfunction of a part or apparatus; "the right front tire had a blowout"; "as a result of the blowout we lost all the lights"
PrepTutorEJDIC
- 〈U〉(特に)骨を折ること;骨を折った状熊 / 〈C〉割れ(裂け)目,(鉱物の)破砕面 / 〈足・腕などを〉‘を'骨折する;…‘を'砕く / 骨折する;砕ける
- (タイヤの)パンク, / (ヒューズ)の吹き飛ぶこと / (油・ガスの)漏出
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/05 18:06:33」(JST)
[Wiki en表示]
| Blowout fracture |
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An orbital blowout fracture of the floor of the left orbit.
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| Classification and external resources |
| ICD-10 |
S02.3 |
A blowout fracture is a fracture of the walls or floor of the orbit. Intraorbital material may be pushed out into one of the paranasal sinuses. This is most commonly caused by blunt trauma of the head, generally personal altercations. Orbital floor fractures were investigated and described by MacKenzie in Paris in 1844[1] and the term blow out fracture was coined in 1957 by Smith & Regan,[2] who were investigating injuries to the orbit and resultant inferior rectus entrapment, by placing a hurling ball on cadaverous orbits and striking it with a mallet. The force of a blow to the orbit is dissipated by a fracture of the surrounding bone, usually the orbital floor and/or the medial orbital wall. Serious consequences of such injury include diplopia in upgaze where there is significant damage to the orbital floor. In blowout fractures, the medial wall is fractured indirectly. When an external force is applied to the orbital cavity from an object whose diameter is larger than that of the orbit, the orbital contents are retropulsed and compressed. The consequent sudden rise in intraorbital pressure is transmitted to the walls of the orbit, which ultimately leads to fractures of the thin medial wall and/or orbital floor. Theoretically, this mechanism should lead to more fractures of the medial wall than the floor, since the medial wall is slightly thinner (0.25 mm vs 0.50 mm).[3] However, it is known that pure blowout fractures most frequently involve the orbital floor. This may be attributed to the honeycomb structure of the numerous bony septa of the ethmoid sinuses, which support the lamina papyracea, thus allowing it to withstand the sudden rise in intraorbital hydraulic pressure better than the orbital floor.[4]
Contents
- 1 Signs
- 2 Causes
- 3 Diagnosis
- 4 Treatment
- 5 References
- 6 External links
Signs
Some clinically observed signs include:
- Restricted vertical movement of the eye
- Subconjunctival hemorrhage
- Swollen lid
- Loss of sensation over upper cheek area
- Periorbital (around eye socket) ecchymosis
Causes
Common medical causes of blowout fracture may include:
- Direct orbital blunt injury
- Sports' injury (squash ball, tennis ball etc.)
- Motor vehicle accidents
- Facial trauma
Diagnosis
The most commonly fractured area in blowout fracture is the floor of orbit. Diagnosis is based on clinical and radiographic evidence. Circumorbital (around eye socket) ecchymoses and subconjunctival hemorrhage indicate a possible fracture. On Water's view radiograph, polypoid mass can be observed hanging from the floor into the maxillary antrum, classically known as teardrop sign, as it usually is in shape of a teardrop. This polypoid mass consists of herniated orbital contents, periorbital fat and inferior rectus muscle. The affected sinus is partially opacified on radiograph. Air-fluid level in maxillary sinus may sometimes be seen due to presence of blood. CT scan can also show any soft tissue and bone involvement. Fracture of medial wall can produce subcutaneous emphysema, especially when blowing the nose or while sneezing. Lucency in orbits (on a radiograph) usually indicate orbital emphysema.
Treatment
Surgery is indicated if
- Enophthalmos greater than 2mm
- Double vision on primary or inferior gaze
- Entrapment of extraocular muscles
- Fracture greater than 50% of the orbital floor
When not surgically repaired (for the above indications), most blowout fractures heal spontaneously without significant consequence. Corticosteroid therapy may be used to reduce swelling. Antibiotics are usually given as prevention of infection. Surgical repair of a "blowout" is rarely undertaken immediately; it can be safely postponed for up to two weeks, if necessary, to let the swelling subside. Surgery to place an orbital implant leaves little or no scarring and the recovery period is usually brief. Hopefully, the surgery will provide a permanent cure, but sometimes it provides only partial relief from double vision or a sunken eye[5]
References
- ^ Ng P, Chu C, Young N, Soo M. (Aug 1996). "Imaging of orbital floor fractures.". Australas Radiol. 40 (3): 264–268. doi:10.1111/j.1440-1673.1996.tb00400.x. PMID 8826732.
- ^ "Blowout fracture of the orbit: mechanism and correction of internal orbital fracture. By Byron Smith and William F. Regan, Jr". Adv Ophthalmic Plast Reconstr Surg 6: 197–205. 1987. PMID 3331936.
- ^ Phan, Laura T., W. Jordan Piluek, and Timothy J. McCulley. "Orbital trapdoor fractures." Saudi Journal of Ophthalmology (2012).
- ^ O-Lee, T. J., and Peter J. Koltai. "Pediatric Facial Fractures." Pediatric Otolaryngology for the Clinician (2009): 91-95.
- ^ Mwanza, J. C. K., D. K. Ngoy, and D. L. Kayembe. "Reconstruction of orbital floor blow-out fractures with silicone implant." Bulletin de la Société belge d'ophtalmologie 280 (2001): 57-62.
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Fractures and cartilage injuries (Sx2, 800–829)
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| General |
- Avulsion fracture
- Chalkstick fracture
- Greenstick fracture
- Pathologic fracture
- Spiral fracture
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| Head |
- Basilar skull fracture
- Blowout fracture
- Mandibular fracture
- Nasal fracture
- Le Fort fracture of skull
- Tripod fracture
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| Spinal fracture |
- Cervical fracture
- Jefferson fracture
- Hangman's fracture
- Flexion teardrop fracture
- Clay-shoveler fracture
- Burst fracture
- Compression fracture
- Chance fracture
- Holdsworth fracture
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| Ribs |
- Rib fracture
- Sternal fracture
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| Shoulder fracture |
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| Arm fracture |
| Humerus fracture: |
- Supracondylar
- Holstein–Lewis fracture
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| Forearm fracture: |
- Ulnar fracture
- Monteggia fracture
- Hume fracture
- Radius fracture/Distal radius
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- Galeazzi
- Colles'
- Smith's
- Barton's
- Essex-Lopresti fracture
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| Hand fracture |
- Scaphoid
- Rolando
- Bennett's
- Boxer's
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| Pelvic fracture |
- Duverney fracture
- Pipkin fracture
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| Leg |
| Tibia fracture: |
- Bumper fracture
- Segond fracture
- Gosselin fracture
- Toddler's fracture
- Pilon fracture
- Tillaux fracture
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| Fibular fracture: |
- Maisonneuve fracture
- Le Fort fracture of ankle
- Bosworth fracture
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| Combined tibia and fibula fracture: |
- Trimalleolar fracture
- Bimalleolar fracture
- Pott's fracture
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| Crus fracture: |
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| Femoral fracture: |
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| Foot fracture |
- Lisfranc
- Jones
- March
- Calcaneal
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Index of bones and cartilage
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| Description |
- Anatomy
- bones
- skull
- face
- neurocranium
- compound structures
- foramina
- upper extremity
- torso
- pelvis
- lower extremity
- Physiology
- Development
- Cells
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| Disease |
- Congenital
- Neoplasms and cancer
- Trauma
- Other
- Symptoms and signs
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| Treatment |
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Index of teeth
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| Description |
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| Disease |
- Developmental
- Jaw
- Neoplasms and cancer
- Injury
- Other
- Symptoms and signs
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| Treatment |
- Dentistry
- endodontology
- orthodontics
- prosthodontology
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External links
- CT Scans of Blowout Fracture from MedPix
- Blow out fracture current management trends
UpToDate Contents
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English Journal
- Correction of Medial Blowout Fractures According to the Fracture Types.
- Chung KJ1, Lim JH, Kim TG, Lee JH, Kim YH.
- Annals of plastic surgery.Ann Plast Surg.2016 Jan;76(1):46-50. doi: 10.1097/SAP.0000000000000560.
- BACKGROUND: Regarding the issue of blowout fracture, a variety of approaches and surgical techniques have been reported to improve postoperative results. However, there are no extant guidelines for the selection of these various methods. The current authors classified the medial blowout fracture int
- PMID 26101981
- Controversies in orbital reconstruction-III. Biomaterials for orbital reconstruction: a review with clinical recommendations.
- Dubois L1, Steenen SA2, Gooris PJ2, Bos RR3, Becking AG2.
- International journal of oral and maxillofacial surgery.Int J Oral Maxillofac Surg.2016 Jan;45(1):41-50. doi: 10.1016/j.ijom.2015.06.024. Epub 2015 Aug 4.
- The goal of orbital reconstruction is to repair trauma defects, to correct the position of the eye anatomically, avoiding enophthalmos, and to restore ocular function. For the reconstruction of (trauma) defects, many surgeons recommend materials that can be bent into an anatomical shape and that pos
- PMID 26250602
- Comparative Study of Naugle and Hertel Exophthalmometry in Orbitozygomatic Fracture.
- Jeon HB1, Kang DH, Oh SA, Gu JH.
- The Journal of craniofacial surgery.J Craniofac Surg.2016 Jan;27(1):142-4. doi: 10.1097/SCS.0000000000002334.
- Accurate perioperative evaluation of enophthalmos is important to determine the adequacy of surgical repair in orbitozygomatic fracture. In this study, the authors evaluated the degree of enophthalmos using Hertel and Naugle exophthalmometry in patients with pure blowout fracture and orbitozygomatic
- PMID 26674913
Japanese Journal
- Blowout fractureにおける骨移植術 (特集 これを読めばすべてがわかる!骨移植)
- CLINICAL INVESTIGATION : Orbital blowout fracture location in Japanese and Chinese patients
- Sun Michelle T.,Wu Wencan,Watanabe Akihide [他]
- Japanese journal of ophthalmology : the official international journal of the Japanese Ophthalmological Society 59(1), 65-69, 2015-01
- NAID 40020328438
- 石井 秀将,羽嶋 正明,津村 薫 [他],河野 崇志,岩田 和宏
- 耳鼻咽喉科臨床 108(7), 517-523, 2015
- … We retrospectively evaluated 13 cases of orbital fracture in children younger than 15-year-old treated at Hiroshima City Asa Hospital from 2006 to 2012. … Among them, two cases (20%) had the punched-out type of fracture, three cases (30%) had open-door type fracture, and five cases (50%) had linear-type fracture. … All of the five cases with linear-type fracture required urgent surgical intervention. …
- NAID 130005084926
Related Links
- What is a “blowout” fracture? A blowout fracture is a fracture of one or more of the bones surrounding the eye and is commonly referred to as an orbital floor fracture. What is the orbit? The orbit consists of the bones surrounding the ...
- Orbital blow-out fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact. Typically, this is caused by a direct blow to the central orbit from a fist or ball.EpidemiologyThe blow-out fracture is ...
Related Pictures
★リンクテーブル★
[★]
- 英
- blow out fracture, blow-out fracture, blowout fracture
- 関
- 眼窩吹き抜け骨折、眼窩底吹き抜け骨折
[show details]
- 眼窩部を強打された場合に生じる眼窩底や眼窩上蓋の骨折
国試
[★]