The Orbital Destruction Intensity Classification—An Easy-to-Use, Numerical Scale for Assessing the Severity of Orbital Fractures

TL;DR

This study evaluates a new numerical scale, the Orbital Destruction Intensity (ODI), to assess the severity of orbital fractures and their treatment needs.

Contribution

The study introduces and validates the ODI scale as a practical tool for assessing and classifying orbital fracture severity.

Findings

Assault was the leading cause of orbital fractures, accounting for 39% of cases.

Higher ODI scores correlated with more complex fractures and different treatment approaches.

The ODI scale effectively links injury severity to anatomical classifications and treatment methods.

Abstract

Background/Objectives: Orbital fractures are a very serious problem due to the close location of the eyeball and a direct path to brain injuries, which is associated with serious consequences. This study aims to assess the usefulness of the Orbital Destruction Intensity (ODI) scale. Additionally, this article includes elements of an epidemiological study. Methods: A retrospective study of 160 patients admitted to the Department of Maxillofacial Surgery in Łódź (Poland) between January 2021 and June 2024 was conducted. In this study, general patient information (gender, age), details about the injuries (cause, affected orbit, accompanying symptoms), diagnosis (ODI scale, pathological classification), and treatment were assessed. Analysis of the distribution of features and regression analysis was performed in the case of quantitative data. To compare the assessment of the impact of a categorical variable on a quantitative variable, the Kruskal–Wallis test was used. A p-value of less than 0.05 was considered statistically significant. Results: The main cause of the accident was assault, which accounted for 39% of cases. An X-ray examination showed that patients had an average ODI score of 2.92 ± 1.69. Patients with low ODI scores mostly had isolated fractures of the orbital floor. As ODI scores increased, zygomaticomaxillary complex (ZMCO) fractures became more common as an additional fracture (p < 0.05). For patients with low ODI scores, treatment generally involves reconstructing the orbital wall with titanium mesh. For those with higher ODI scores, treatment may include microplate osteosynthesis or a combination of both methods (p < 0.05). Conclusions: A correlation was observed between the diagnosis based on ODI, anatomical classification, and the treatment provided. This relationship is related to the nature of the ODI scale, as, when the severity of the injury increases, additional anatomical structures (walls or rims of the orbit) are included.

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