Posttraumatic Isolated Rupture of the Lateral Rectus Muscle

We present a case of traumatic rupture of a lateral rectus muscle. A 36-year-old man was hit with a fist in the eye. He came to our hospital 2 days after trauma. He had an orbital hematoma with exophthalmos, an eyelid wound involving the lacrimal duct, and a conjunctival rupture in the temporal quadrant (Fig. 1A). A big fragment of a muscle was exposed (Fig. 1B). Traumatic rupture of a rectus muscle is an in frequent injury, usually associated with extensive orbital and ocular damage. Isolated rupture of a lateral recuts muscle is extremely uncommon.¹ Moreover, in the most of described cases, the laceration occurred near the tendon insertion.² In our case, muscle was complete rupture through the belly, approximately 20 mm of the distal fragment was attached to the globe. Posterior segment examination was normal, and computed tomography showed no orbital fractures Due to necrosis, distal segment of the muscle was excised at its insertion. The proximal fragment was identified and attached with adjustable 6/0 vicryl suture. The muscle was pale and shrunken due to ischemia and unfortunately did not regain its function. The patient had no abduction. However, it had the correct primary eye position without diplopia and full visual acuity.

Figure 1: A, The appearance of the patient at the time of admission to the hospital. Visible orbital hematoma, damage to the lacrimal duct and conjunctival rupture. The dark piece of tissue in the temporal part attracts attention. B, The enlarged photo clearly shows that the protruding part is in fact the severed belly of the muscle. The wound was contaminated and necrotic.