Prediction of the Likelihood of Surgical Management in Blow-out Fracture Patients: Using Two CT Measuring Method, DFD and CCD

Kwak, Sang Hoon; Choi, Han Sung; Lee, Jong Seok; Jeong, Ki Young; Hong, Hoon Pyo; Ko, Young Gwan

J Korean Soc Emerg Med > Volume 28(6); 2017 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2017;28(6): 595-601.

응급실에서 파열골절 환자의 수술여부를 예측하는 새로운 방법: CT에서 DFD를 CCD와 비교하여

곽상훈, 최한성, 이종석, 정기영, 홍훈표, 고영관

경희대학교병원 응급의학과

Prediction of the Likelihood of Surgical Management in Blow-out Fracture Patients: Using Two CT Measuring Method, DFD and CCD

Sang Hoon Kwak, Han Sung Choi, Jong Seok Lee, Ki Young Jeong, Hoon Pyo Hong, Young Gwan Ko

Department of Emergency Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea

Correspondence

Han Sung Choi ,Tel: 02-958-8274, Fax: 02-958-9689, Email: hsg3748@hanmail.net,

Received: June 27, 2017; Revised: June 28, 2017 Accepted: September 29, 2017. Published online: December 31, 2017.

ABSTRACT

Purpose:
The purpose of this study was to evaluate the predictive value of the measured factors that can be used in an emergency department to assess patients with blow-out fractures (BOFs) who are expected to undergo surgical management.
Method:
This study was conducted on patients with BOFs who attended an emergency department in a tertiary teaching hospital from December 2013 to November 2016. The medical records and radiology findings, such as facial computed tomography (CT), were reviewed retrospectively. The depth of floor displacement (DFD) and cranial-caudal dimension (CCD), which were measured using facial CT, were evaluated to determine the power of the CT parameters as predictors expecting surgical management in BOF patients. Statistical analysis was conducted with SPSS statistics ver. 23.0.
Results:
The final 44 BOF patients were included in the study. Among them, 21 patients had undergone surgery. From this study, using a threshold DFD value of 0.5 cm, the accuracy of DFD was 86.36%, and the sensitivity and specificity in predicting surgery in BOF patients was 100% and 73.91%, respectively. Using a threshold CCD value of 0.4 cm, the accuracy of CCD was 88.64%, and the sensitivity and specificity in predicting surgery in BOF patients was 100% and 78.26%, respectively.
Conclusion:
With the aid of DFD and CCD, which was measured from facial CT, BOF patients who may require surgical management can be detected easily and more promptly by emergency physicians in emergency settings.

Key words: Orbital fractures, Prognosis, Emergency medicine, Hospitals