Orbital wall fractures are common among cases of facial trauma. Elective surgery will be performed in most cases, but it is difficult to decide the indications of surgery at an early stage because of facial swelling. We retrospectively analyzed cases of orbital wall fracture treated at the department of plastic and reconstructive surgery of Japanese Red Cross Fukui Hospital between 2007 and 2016, and investigated the surgical indications of orbital wall fractures. In total, there were 94 cases, 37 of which underwent surgery. We found that surgery was highly likely to be necessary in cases of inferior wall fracture, multiple medial and inferior wall fractures, burst-type fracture, and fractures reflecting damage beneath the eyeball. In particular, burst-type fractures of the inferior wall, multiple burst-type fractures of the medial and inferior wall, and fractures beneath the eyeball had high surgical rates. In addition, patients in whom the length of herniated orbital tissue exceeded 10 mm or those who had a large volume of herniated tissue were likely to undergo surgery. These trends will be useful in deciding the surgical indication for orbital wall fractures.
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