Full 2L QBank
Surgery General 49859bfe

Which of the following condition is not indicated for surgical exposure of orbital floor in ZMC fracture?

A
Diplopia
B
Oedema
C
Enopthalamos
D
Non-resolving occulocardiac reflex
High-Yield Explanation
The decision to intervene should be based on signs, symptoms,  and  functional  impairment. The decision need not be made hastily because ZMC fractures are not emergencies and treatment can be delayed, if necessary. However, during the first week following trauma, the soft tissue  undergoes  changes  consistent  with  the  usual sequence of wound healing. The form that they will ultimately  take  depends  on  the  underlying  bony architecture. Optimally,  fractures  are  treated  before the onset of edema from the traumatic incident. In practice, however, such timing of treatment is rarely possible.  When  edema  is  moderate  to  severe,  postponement  of surgery  for  several  days  makes  thorough  examination and  surgical  treatment  reliable  and  much  easier  tasks. Therefore,  postponement  of  the  decision  to  operate until  facial  edema  resolves  is  recommended  when  the necessity for intervention is questionable. This approach may  be  used  in  fractures  that  are  minimally  displaced, when  radiographic  examination  of  the  internal  orbit shows  no  major  defects.  However,  if  the  radiographic findings  are  so  dramatic  that  intervention  is  definitely necessary, it may be advantageous to perform the surgery regardless of the facial edema present, because the final soft  tissue  contour  may  be  superior  to  that  which  may occur when surgery is postponed. If the surgeon decides not to intervene, the patient should be observed for 2 to 3 weeks and a soft diet should be prescribed. One should always remember that if a force is sufficient to produce a fracture of the zygoma, it is also sufficient  to  produce  intracranial  injuries.  ZMC  fractures are not life-threatening injuries and should not be given priority over more acute problems. Treatment need not be hastened if the neurologic state of the patient is in question  because  zygomatic  fractures  can  be  satisfactorily  treated  in  several  days,  after  the  facial  edema  has resolved. Ref: Fonseca 4th ed page no 363

Related Surgery MCQs

Practice 2,00,000+ NEET PG Questions Free

Timed mock tests, mistake queue analytics, audio lectures & zero attempt limits on i❤️Exams.

Start Free Mock Test Now