scholarly journals Treatment of a Penetrating Intraorbital Injury by Rubber Projectile

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1604033
Author(s):  
Laís Pinto ◽  
Alan Motta do Canto ◽  
José Vital Filho ◽  
Ronaldo Rodrigues de Freitas

Penetrating injuries caused by rubber projectiles are classified as low-velocity injuries. When the midface is affected, these can cause fractures, eye injuries, and even blindness. Unlike conventional projectiles, the removal of rubber projectiles involving the orbit and correction of associated fractures are mandatory for preventing infection and anophthalmic orbit syndrome, which is characterized by enophthalmos of the prosthesis, superior sulcus depression, and lower eyelid ptosis. This article aims to describe a case of penetrating injury by rubber projectile, associated with the removal and late reconstruction of the orbital walls, and to show the results obtained.

2006 ◽  
Vol 134 (1-2) ◽  
pp. 11-21 ◽  
Author(s):  
Milos Jovanovic

Introduction. Some factors significant for development of mechanical injuries of the eyeball have been analyzed in the study. Objective. Basic objective of such analysis was prevention and reduction of these injuries. Method. Mechanical injuries of the eyeball in patients hospitalized at the Institute of Eye Disease, CCS in Belgrade, in five year period have been analyzed. Only patients with severe eye injuries were hospitalized. The following parameters were analyzed: sex, age, occupation of patients, residence, time of the inflicted injury, i.e. by months in a year, days in a week and hours in a day, place and way of inflicting the injury as well as visual acuity on admission. In addition, the type of injury was analyzed, i.e. contusion or penetrating with all resulting complications. Finally, the timing of primary surgical management of the eye injury was specified, if required. Results. A total number of hospitalized patients with mechanical eye injuries was 1642 during the last five years, meaning that one injury occurred daily. There were 1381 males and 261 females, meaning that males were 5.3 times more the victims of mechanical eye injuries. Out of all the injured, 861 (52.4%) were from rural environment, while 781 (47.6%) were urban population. The proportion of injuries of the right or the left eye was nearly equal, while both eyes were simultaneously injured in 21 (1.3%) cases. The injuries were inflicted in all ages, but most frequently in working population ranging from 16 to 55 years, accounting for 60.8%. Unfortunately, a lot of the injured were children up to 15 years of age - 19.4%. The most commonly injured were workers - 39.8%, followed by students - 17.5%. A piece of wood was the cause of injury in 21.8%, sharp and pointed objects in 17.2%, hammer and metal in 14.2%, glass in 11.6%, and other different causes in varying percentage. There were also rare causes of injuries, such as those caused by zip, dog bite, rooster?s bill, etc. According to months in a year and days in a week, the injuries were almost evenly distributed. Considering the period of a day, even 77.4% of the injuries occurred during daytime, from 10 a.m. to 10 p.m. The highest percentage - 43.5% - of the injuries occurred while working something out of working place, while 24.5% of injuries were inflicted at working places. On admission, the majority of patients - 32.9% had visual acuity L+P+, but this visual acuity ranged from amaurosis to 1.0. There were 746 (45.4%) contusion injuries and 870 (53.0%) penetrating injuries. The rest were the injuries of other ocular adnexa. The majority of primary wound managements were performed in the first 24 hours of the injury - 67.1%. Conclusion. It may be concluded that working population and students are most commonly injured, and that men are five times more frequently injured than women; then, a piece of wood, sharp objects and glass are the most often causes of injury; the number of contusion and penetrating injuries is equal, and that required primary surgical wound management is most often performed in the first 24 hours from the injury. Further analysis of these factors suggests that many of these injuries could have been prevented, and consequently long-term treatment and treatment costs could have been evaded. Most important is that permanent disability due to visual impairment or even blindness of the injured eye could have been avoided.


2014 ◽  
Vol 7 (4) ◽  
pp. 310-312 ◽  
Author(s):  
AndrewPeter Dekker ◽  
AbdelHamid El-Sawy ◽  
DariusStephen Rejali

The objective of this study was to present an unusual low velocity transorbital penetrating injury. The study design was a clinical record (case report). A 38-year-old gentleman tripped and fell face first onto the wing of an ornamental brass eagle. This penetrated the inferomedial aspect of the right orbit, breaching the lamina papyracea to extend into the ethmoid sinuses and reaching the dura of the anterior cranial fossa. The foreign body was removed in theater under a joint ophthalmology and ENT procedure. The patient was left with reduced visual acuity in the right eye but no other long-term sequelae. Transorbital penetrating injury presents unusual challenges to investigation and management requiring a multidisciplinary approach to prevent significant morbidity and mortality. If managed well the prognosis is good.


1983 ◽  
Vol 72 (3) ◽  
pp. 293
Author(s):  
William B. Nolan ◽  
Lars M. Vistnes ◽  
Charles K. Beyer

2020 ◽  
pp. 102490792090419
Author(s):  
Quinten GH Rikken ◽  
Abdes Chadid ◽  
Joost Peters ◽  
Leo MG Geeraedts ◽  
Georgios F Giannakopoulos ◽  
...  

Background: Penetrating injury can encompass a large spectrum of injuries dependent on the penetrating object, the location of entry, and the trajectory of the object through the human body. Therefore, the management of penetrating injuries can be challenging and often requires rapid assessment and intervention. No universal definition of penetrating injury exists in the literature and little is known about the demographics and outcome of penetrating injury in the Netherlands. Objective: A research was carried out to ascertain the size and outcome of penetrating injuries in two level-one trauma centers in the Netherlands. Methods: Using the trauma registry of the Radboud University Medical Center in Nijmegen and VU University Medical Center in Amsterdam, all patients with penetrating injury were identified who were admitted to these level 1 trauma centers in the period between January 1, 2009, and January 1, 2014. Penetrating injury was defined as an injury that caused disruption of the body surface and extended into the underlying tissue or into a body cavity. Data concerning age, gender, mechanism of injury, Glasgow Coma Scale, number of injuries, type of injury, and Injury Severity Score were collected and analyzed. Patient results were stratified by Injury Severity Score. Results: In total, 354 patients were identified, making up around 2% of all admitted trauma patients 3.1% (VU Medical Center) and 1.6% (Radboud Medical Center). Patients were overwhelmingly male (83.1%) and median age was 36 years (range = 1–88 years). Most injuries were caused by stabbings (51.1%) followed by shootings (26.3%). Admission to the intensive care unit occurred in 41.1% of all patients. Median stay in the intensive care unit was 5.1 days (range = 1–96 days) and median total hospital stay was 8 days (range = 1–95 days). Mortality among these patients was 7.1%, ranging from 0% among patients with Injury Severity Score 1–8 to 100% in patients with Injury Severity Score > 34. High mortality figures were associated with injuries caused by firearms (19.4%), injuries to the head (27.9%), and alleged assaults (10.9%). Differences in demographics between the two centers were not significant. Conclusion: Penetrating injury is a relative rare occurrence in the Netherlands compared with other countries. It is associated with high mortality and substantial hospital costs. The incidence of penetrating injuries is higher in metropolitan areas than in rural areas. A universal definition of penetrating trauma should be agreed upon in order to ensure that future studies remain free of bias, and also to ensure that data remain homogeneous.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2094056
Author(s):  
Abhinav Kumar ◽  
Narendra Choudhary ◽  
Soumya Ghoshal ◽  
Harshit Agarwal

Penetrating trauma is one of the most common cause of occult vascular injury, especially in low velocity penetrating injury. This is usually in pretext of an innocuous looking small external wound. It is important for clinician to have high index of suspicion for such types of injuries, as the clinical examination with presenting signs and symptoms may be deceptive. Radiological evaluation is of paramount importance and essential to rule out any occult vascular insult. Conventional open surgical exploration is the gold standard for vascular injuries in neck. Minimal invasive endovascular stenting has selective role based on zone of neck, mechanism of injury, hemodynamic stability, neurological status and resource availability at treating centre. Early diagnosis and referral to an appropriate higher centre, preferably a trauma centre with expertise in handling major vascular injuries, improve the outcome. We present a case report of small innocuous looking external wound harbouring major central vessel injury underneath following low-velocity penetrating injury.


Author(s):  
N.V. Mashchenko ◽  

Purpose. Evaluation of the frequency, structure and severity of the eye injuries, the effectiveness of the implementation of primary surgical treatment (PST) and the outcomes of their surgical treatment. Material and methods. In just a period from the end of March to December 2020, in the Khabarovsk branch the S. Fyodorov Eye Microsurgery Federal State Institution received 51 patients with various as penetrating (48 eyes) and imperriburing injuries of the eyeball (3 eyes). Their age varied widespread from 5 to 56 years (on average 35.5 years). Men were dominated among them – 44 people, women – 7 people. Adults were 49 people, children – 2 people. Results. Under the conditions of obtaining penetrating injuries, household injuries were isolated – 33 eyes (65%), production – 15 eyes (29%). The contusion injury of the eye was criminal, which was 6% (3 eyes). According to the localization of penetrating injuries or the impact of mechanical damage, they were presented: corneal wounds – 12 eyes, rootless – 17 eyes, scleral – 18 eyes. In 13 eyes, there was an intraocular foreign bodies (IFB). Conclusion. Thus, for the period from April to December 2020, in our branch, PST eyes were performed about 47 heavy penetrating injuries, including the introduction of IFB in 13 eyes, 4 eyes with extensive damage to conjunctiva. Among the victims were 49 adults and 2 children. Key words: penetrating eye wound, intraocular foreign body, microgery surgery, traumatic retinal detachment.


1983 ◽  
Vol 72 (3) ◽  
pp. 289-292 ◽  
Author(s):  
William B. Nolan ◽  
Lars M. Vistnes

Author(s):  
David Jordan ◽  
Louise Mawn ◽  
Richard L. Anderson

A diffuse connective tissue framework exists within the orbital space that supports various orbital structures, maximizing their function and maintaining anatomic relationships between them. Some connective tissue septa are aligned with directions of force and serve to resist displacement of the extraocular muscles during contraction. Other fascial septa suspend and support delicate orbital vascular and neural elements. All orbital structures, including the periorbita, globe, optic nerve, and extraocular muscles, are involved in the organization and suspension of these extensive connective tissue septal systems. This intricate framework has several important components that are oft en difficult to see clinically and during orbital surgery but which must always be kept in mind as playing a role in the clinical presentation of a particular orbital problem. For example, a blowout fracture of the orbital floor with restricted motility in upgaze might be due to entrapment of the inferior rectus muscle within the fracture, but more commonly it is due to entrapment of the connective tissue framework + / − fat in the inferior orbit. Enophthalmos, a deep superior sulcus, ptosis, and lower eyelid malposition are commonly seen following enucleation surgery. Loss of volume (of the globe) certainly plays a role, but other contributing factors, including a disruption of the connective tissue framework (which helps support the globe), might be playing a role. Trauma to Tenon’s capsule, Whitnall’s ligament, Lockwood’s ligament, or check ligaments associated with the recti muscles, as well as the intermuscular fascial connections, might also contribute to the postenucleation socket abnormalities mentioned above, as their disruption allows the shifting of orbital tissues to occur. Evisceration surgery is associated with less disruption to the connective tissue framework, and as a result features of postenucleation socket syndrome other than loss of volume are not as common. Historically, four major connective tissue components in the orbit have been described: 1. the bulbar fascia, or Tenon’s capsule, which surrounds the globe; 2. the fascial sheaths of the extraocular muscles; 3. the intermuscular septum (the common muscle sheath connecting the four rectus muscles); and 4. the medial and lateral check ligaments.


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