Evaluation of a Radiological Score in the Management of Pure Fractures of the Orbital Floor.

Abstract

The authors had for aim to further assess the predictive power and the relevance of a previously published radiological decision taking score for pure fractures with recording of clinical data. The authors retrospectively included all patients managed in the authors' department for a pure orbital floor fracture, from June 2012 to November 2013. The authors collected clinical data including diplopia and enophtalmos, at initial status and after 3-months of follow-up. The radiological data was also recorded: rate of the fractured orbital floor, maximal height of periorbital tissue herniation, and a 4-grade muscular sub score. The treatment determinants were assessed by univariate analysis, with χ tests or Fisher exact tests for qualitative variables, and Student t tests for quantitative ones. A multivariate analysis was then performed with a stepwise logistic regression. The authors included 90 patients. The authors proposed a simple score (with a specificity of 79% and a sensitivity of 56%) for the indication to operate, using the rate, which was a significant predictor of treatment in the multivariate analysis. The authors' study is another step in the standardization of treatment decision for pure orbital floor fractures. The proposed score requires further clinical research to be validated but already helps to compare series of patients.