Clinical and radiographic assessment of early versus delayed reduction in orbital trauma: Randomized Clinical Trial (RCT)

Document Type : Original Article

Authors

1 Lecturer of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt

2 Assistant Professor of Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt

3 Lecturer of Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt

4 Lecturer of Oral and Maxillofacial surgery Department , Faculty of Dentistry , The British university, Cairo, Egypt

Abstract

Aim of the study: This study aimed at clinical & radiographic assessment of early versus delayed reduction in orbital fractures.

Methodology: Twenty patients with orbital fractures were randomly allocated equally into two groups; Group I underwent Open reduction internal fixation (ORIF) within the first week following the trauma; meanwhile the other group (Group II) underwent delayed surgical intervention (ORIF) more than two weeks after the trauma. Clinical assessment was conducted to precisely evaluate any limitations in ocular motility and the presence of diplopia. For radiographic assessment, each patient underwent computed tomography (CT) scanning twice. Preoperative CT scans were performed to evaluate bone structures and fractures, while immediate postoperative CT scans were obtained to assess globe positioning in terms of exophthalmos or enophthalmos and to measure orbital volume for comparison with the unaffected contralateral side.
Results: All patients in both Groups I & II exhibited a 2 mm improvement in enophthalmos/exophthalmos. All cases of infraorbital hypoesthesia resolved by the final follow-up, and no complications related to orbital implants occurred. In terms of orbital volume, Group I had an average postoperative volume of 31.87 mm³ in the fractured orbits, compared to 38.36 mm³ in the contralateral orbits (P = 0.003). Group II showed a postoperative volume of 30.19 mm³ in fractured orbits and 34.43 mm³ in contralateral orbits (P = 0.023); reflecting significant improvement in both groups with no significant difference.
Conclusion: Both groups showed comparable results in terms of clinical and radiographic outcomes.

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Egyptian Dental Journal
Volume 71, Issue 4 - Serial Number 2
October - Oral Surgery
October 2025
Pages 2917-2927

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