After building himself back to return to the Basketball Universe, Chicago’s Prize Bull was quite literally knocked out of his orbit in late September. After the 27 year old point guard took an elbow to his left eye in practice, Derrick Rose sustained an orbital fracture that required surgery. After sticking to his recovery regimen, which involved avoiding strenuous activity while his eye swelling decreased, his doctors cleared him for minimal play with a facemask in the last Bulls preseason game. Rose still admits to some"double vision,” but is expected to play some minutes in the 2015-16 season opener against the Cleveland Cavaliers.
The nuts-and-bolts of Rose's injury is fairly simple: Your eyeball lays in its socket, designed almost like a hammock of bones . There really isn’t much room for anything else to move in and set up shop. Imagine if all the tissue around the eye is swollen (lets say, from being elbowed), that space becomes way too crowded. From here, one of three things can happen:
1. You choose to stop doing whatever it is you were doing that resulted in the blow to your face.
2. You suffer an orbital blow-out fracture, the more common result amongst fighters.
3. Your eye could burst open/fall out of your face in effort to relieve pressure in the orbital.
The characteristic points of weakness in the orbit are the floor and the medial wall. The logic of the old saying “pressure busts pipes” works perfectly here. At some point the pressure has to be relieved by something, and in controlled settings this can be done surgically. The floor of D-Rose's eye-socket (the maxilla) sits right above a sort of air-sac, and when the pressure became too great- BAM! Like a trapdoor in the floor, the orbital floor breaks. At first, this is great news for your eyeball because now the blood vessels, nerves and muscles aren't getting pinched (which could obviously lead to all sorts of badness). The bad news is this pressure-relief system doesn’t have an off-switch. With continued swelling, contents of the orbit may herniate through the fracture defect and cause double-vision.
How is it fixed?:
Depending on the severity and location of the fracture treatment may vary. In this case, Rose had an open reduction and internal fixation of his orbit. Surgical repair of orbital and maxillofacial fractures typically involves several steps:
Exposure with degloving the facial skeleton.
Anatomic reduction.
Rigid fixation with replacement of lost or damaged bone.
Soft-tissue resuspension.
Closure
To repair the break itself, the material used depends on the surgeons preference. Titanium and polylactide plates are the two most commonly used materials.
Any risks?:
Intraoperative complications include, but are not limited to, the following:
Globe and optic nerve injury caused by direct trauma, excessive retraction, or vascular compromise
Injury to the infraorbital nerve Inadequate reduction of prolapsed tissue Orbital hemorrhage Postoperative complications include, but are not limited to, the following:
Blindness
Persistent diplopia
Globe malpositioning, particularly enophthalmos or hypoglobus
Infection that presents as orbital cellulitis
Infraorbital nerve dysfunction in an orbital floor repair Lid malpositioning, especially lower-lid retraction or entropion
Implant infection, migration, or extrusion
Epistaxis leakage in medial wall repairs Sinus disease, especially sinusitis
We wish D+Rose a speedy recovery back to his epic comeback story. (Cue "Eye of the Tiger";)
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