Orbito-cranial injuries caused by penetrating non-missile foreign bodies. Experience with eighteen patients

Background. Penetrating non-missile orbito-cranial injuries are uncommon civilian injuries which have some special features. Only limited case-reports are available in the international literature. Method. We present a retrospective review of 18 such in presumed trivial orbital injury. Early identification and removal of retained foreign body fragments was achieved within 36 hours. Findings. Patients were operated on and followed up for at least of 3 years. The final clinical outcome was excellent: 16 had a Glasgow Outcome Scale (GOS) of 5 while in the remaining 2 it was 4. Conclusion. The present report indicates that good results, in managing such injuries, can be achieved by a high index of suspicion and early diagnosis of intracranial injury in presumed trivial wounds and by the removal of every possible retained foreign body.