Duvernay Fracture

Duvernay Fracture

Duvernay fracture is also known as a transorbital tear. This is a serious injury to the eye that occurs when the eyeball is pushed through the orbit (the tube inside the head containing the eyeball). This requires immediate surgery and further treatment.

**Causes of injury** Duvergne's fracture occurred in one of the French scientists. As a result of this, he lost his sight. In 1722, scientist Jean Guillaume Duvernay conducted experiments on himself. He was a surgeon and wanted to know exactly what kind of injury he would get if something got damaged. The experience was a success. The scientist put dirt in his own nose to see the consequences of this procedure. Heavy bleeding appeared, which led to such sad consequences. *Look at the patient's original x-ray*:

For such a severe injury, there was deformation of the orbit and lateral displacement of the eyeball by more than a millimeter. The eyeball was located between the cornea and the hard tissues of the skull, and Duvernay could not live with such a “gift.” Therefore, he decided to commit suicide at the age of 17. He was found hanged in the morning. Death occurred on November 2. The causes of death were announced: “Retinal detachment after a blow to the nose!” This story ended in a banal way. Indeed, such consequences could occur, but there was a simple way to check. After the operation, the patient was given extremely poor vision. To avoid complications, special pepper scarves were used. Such measures prevented the possibility of pus leaving the eye sockets. Injuries like Duverney's are called *symmetrical*. With facial symmetry, the injury causes such severe damage that it can be difficult to distinguish between loss of vision and absence of vision. It is very good if at least the mobility of the visual muscles in the inner part of the optic nerve is preserved. At least, in this way the ability to see with light is lost, and due to the ability to distinguish movements, there remains a chance to preserve one’s heat. In principle, completely symmetrical optic nerve lesions have a low chance of a positive outcome. Thus, the diagnosis of *total blindness* after a “Duvernier fracture” seems incredible. A completely disfigured face is the only true indicator of the inability to see anything at all. The absence of any reaction of the pupil is the same evidence of a complete lack of visual function as the inability to rotate the pupil at the site of the rupture. Both indicate a lack of nerve signal and blindness due to damage to the sympathetic nerve.



A Duvernay fracture is a fracture characterized by damage to the cartilaginous structures of the larynx and trachea and occurs mainly in patients aged 20 to 50 years. The diagnosis of Duvernay Fracture is based on a combination of data obtained from clinical studies and, as a rule, requires instrumental diagnostics to establish the diagnosis. This type of fracture is the reason for the majority of tracheolaryngectomies in the world. The outcome of treatment for Duvernay's helix largely depends on the stage of damage and the time of initiation of adequate therapy. Surgical treatment of a Duverne fracture consists of removing dead cartilage, restoring the ligamentous apparatus, removing necrotic masses and pleura from the respiratory tract, and using local and general anesthetics; the use of pleural drainages is often required; Postoperative management of patients is determined by the state of airway obstruction and the nature of the underlying disease.

Duvernay fracture is a rare pathology occurring mainly in people of working age with an average age of onset of 35-40 years, aggravated by concomitant chronic lung diseases such as bronchiectasis, pneumoconiosis or obstructive bronchitis of smokers. Also, the incidence is higher in people who abuse alcohol. Trauma to the larynx usually occurs. Constant risk factors for the development of a duvernaya fracture are smoking and injuries that lead to rupture and damage to the cartilage tissue of the upper respiratory tract.