[Long-term outcome of surgically treated orbital floor fractures. Apropos of a series of 242 patients].

Over a period extending from January 1993 to December 1995, we treated 242 patients with 268 orbital floor fractures in our department. Surgical indications were broad and relied on clinical criteria (enophthalmos, diplopia, hypoesthesia) and/or CT analysis (bony collapse, extrusion of orbital contents, suspicion of muscular entrapment, dislocation of the infraorbital rim). Two years after surgery, 91% of the patients showed good results (absence of diplopia or severe enophthalmos). The analysis of these results points out that the degree of sequelar enophthamos was not only related to the degree of initial bony collapse but above all to the quality of the bony reconstruction. Sequelar diplopia was linked with the presence of a preoperative diplopia and its severity was a direct function of operative delay. Hypoesthesia in the infraorbital nerve territory was the most common sequela; some were postoperative complications. The type of material used for the restoration of the orbital floor was not involved in the development of these sequela. Our good results suggest that an interventionist attitude is warranted in these kind of fractures, the more so as the X-ray examinations often underestimate injuries.