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首页> 外文期刊>Transactions of the American Ophthalmological Society. >Strabismus due to flap tear of a rectus muscle.
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Strabismus due to flap tear of a rectus muscle.

机译：斜视是由于直肌的皮瓣撕裂引起的。

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摘要

PURPOSE: To present a previously unreported avulsion-type injury of the rectus muscle, usually the inferior rectus, and detail its diagnosis and operative repair. METHODS: Thirty-five patients underwent repair of flap tears of 42 rectus muscles. The muscle abnormality was often subtle, with narrowing or thinning of the remaining attached global layer of muscle. The detached flap of external (orbital) muscle was found embedded in surrounding orbital fat and connective tissue. Retrieval and repair were performed in each case. RESULTS: Fourteen patients had orbital fractures, 7 had blunt trauma with no fracture, and 9 had suspected trauma but did not undergo computed tomographic scan. Five patients experienced this phenomenon following retinal detachment repair. Diagnostically, the predominant motility defect in 25 muscles was limitation toward the field of action of the muscle, presumably as a result of a tether created by the torn flap. These tethers simulated muscle palsy. Seventeen muscles were restricted away from their field of action, simulating entrapment. The direction taken by the flap during healing determined the resultant strabismus pattern. All patients presenting with gaze limitation toward an orbital fracture had flap tears. The worst results following flap tear repair were seen in patients who had undergone orbital fracture repair before presentation, patients who had undergone previous attempts at strabismus repair, and patients who experienced the longest intervals between the precipitating event and the repair. The best results were obtained in patients who underwent simultaneous fracture and strabismus repair or early strabismus repair alone. CONCLUSIONS: Avulsion-type flap tears of the extraocular muscles are a common cause of strabismus after trauma, and after repair for retinal detachment. Early repair produces the best results, but improvement is possible despite long delay.
机译：目的：介绍以前未报告的直肌（通常是下直肌）撕脱型损伤，并详细说明其诊断和手术修复。方法：35例患者接受了42条直肌的皮瓣撕裂修复。肌肉异常通常很细微，剩余的附着的整体肌肉层变窄或变薄。发现外部（眼眶）肌肉的游离皮瓣嵌入周围的眼眶脂肪和结缔组织中。在每种情况下都进行了检索和修复。结果：14例患者发生眼眶骨折，7例钝性外伤，无骨折，9例怀疑外伤，但未进行计算机断层扫描。五名患者在视网膜脱离修复后经历了这种现象。在诊断上，25块肌肉中主要的运动缺陷限制在肌肉的作用区域，这大概是由于皮瓣撕裂造成的系绳。这些系绳模拟了肌肉麻痹。限制了17个肌肉的活动范围，从而模拟了陷害。皮瓣在愈合过程中所采取的方向决定了所产生的斜视模式。对眼眶骨折表现出凝视限制的所有患者均出现皮瓣撕裂。皮瓣撕裂修复术后最差的结果是，在就诊前进行过眼眶骨折修复的患者，以前曾进行过斜视修复的患者以及在沉淀事件和修复之间经历了最长间隔的患者。在同时进行骨折和斜视修复或仅早期斜视修复的患者中获得最佳结果。结论：眼外肌撕脱型皮瓣撕裂是外伤后以及视网膜脱离修复后斜视的常见原因。尽早维修可取得最佳效果，但尽管延误很长，但仍可以改善。

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