14-year-old boy injured his right eye while playing basketball, delayed surgery for 20 days, may leave sequelae – Hangzhou News Center – Hangzhou.com
Occult Fracture: A Hidden Threat to Children’s Vision
A 14-year-old boy, Xiao Han, recently suffered an occult fracture while playing basketball, which could have led to severe consequences if not treated promptly. This type of fracture is often overlooked, but it’s essential to recognize the symptoms and seek medical attention immediately.
The Incident: A Basketball Injury
Xiao Han and his classmates were playing basketball when he accidentally got hit in the right eye. The initial symptoms were redness, swelling, and pain, which subsided after a few days. However, he soon developed blurred vision and double vision, especially when looking up. The right eyeball was also swollen and painful when turned upwards, and the double vision symptoms intensified.
The Diagnosis: A Fracture of the Lower Orbital Wall
A CT scan at a local hospital revealed that Xiao Han had a fracture of the lower wall of his right orbit and needed surgery. The repair materials required for the surgery were special and needed to be self-absorbed, which limited the number of hospitals that could perform the operation. After several visits, Xiao Han’s parents took him to see Dr. Fang Weishi, a specialist at the Hangzhou Branch of Zhejiang Eye Hospital (Ophthalmology and Optometry Hospital Affiliated to Wenzzhou Medical University), about 20 days after the injury.
The Treatment: A Delicate Surgery
Dr. Fang Weishi, Deputy Chief Physician, explained that the child’s right eye could not be turned properly, and there was obvious pain when turning, which was consistent with the CT image showing a fracture of the right inferior orbital wall. The fracture was accompanied by the inferior rectus muscle and surrounding tissues being incarcerated at the fracture site, requiring surgical treatment as soon as possible. The actual range of the fracture was larger than that shown on the CT image, which is common in children and adolescents due to their high bone elasticity. The surgery involved using special materials that would be self-absorbed, and the goal was to release the incarcerated muscle and surrounding tissues.
The Consequences: Delayed Treatment Can Lead to Sequelae
Dr. Fang Weishi emphasized that if the incarceration lasts for a long time, it can cause muscle dysfunction. Even if surgery is performed later, there is a certain probability of sequelae, such as incoordination of binocular vision and double vision. Additionally, damage to the sensory nerves can lead to facial paralysis. The ideal time for surgery is within 24-48 hours after the injury, but due to the relatively hidden symptoms and the smaller fracture range on the examination image, treatment is often delayed. In Xiao Han’s case, the actual fracture range was four or five times larger than the CT image, but he was lucky to have recovered well after the surgery.
The Importance: Recognizing the Symptoms and Seeking Medical Attention
Dr. Fang Weishi stressed that occult fractures can occur in children and adolescents, especially those who participate in competitive sports like basketball or football. If similar symptoms occur, it’s essential to seek medical attention immediately. Delayed treatment can lead to worse muscle function recovery. In one case, a patient who did not seek medical treatment in time can only move their injured eyeball to two-thirds of the normal level.
Conclusion: Early Detection and Treatment Are Crucial
Occult fractures can have severe consequences if not treated promptly. It’s essential to recognize the symptoms and seek medical attention immediately. Early detection and treatment can help prevent sequelae and ensure a good recovery. As Dr. Fang Weishi said, “If you experience similar symptoms, you must pay attention and treat them in time. The longer you delay, the worse the muscle function will recover.”