OBJECTIVES:
Traumatic rupture of a rectus muscle is an infrequent injury, usually associated with extensive orbital and ocular damage. Besides, isolated rupture of a lateral recuts muscle is extremely uncommon.The purpose of this study is to present our experience for the diagnosis and treatment of a case diagnosed with panfacial fracture with isolated lateral rectus muscle disruption, which is rarely reported in the literature.


MATERIALS AND METHODS:
We presented a case with panfacial fracture (LeFort III - II - I, palate, bilateral orbital floors, mandible parasymphysis, bilateral condyle, nasal) after traffic accident. Open reduction and internal fixation over midface, bilateral orbital floor, mandible and bilateral condyle was done initially. However, strabismus was found. Due to orbital plate malposition was suspected on computed tomography(CT) scan, the patient then underwent bilateral orbital plate adjustment. But esotropia(OD) was still found. After the throughout review over all the CT scans by plastic surgeons with ophthalmologists, lateral rectus muscle disruption (OD) with esotropia (OD) was finally diagnosed. Then the patient received orbitotomy for repair of lateral rectus muscle (OD). Due to limited improvement of estropia(OD), medial rectus muscle maximal recession (OD) was done three months later.
All the CT scans and reports were done in a single center.
Postoperative evaluations were done at clinic and with exams by ophthalmologists. Follow-up period is 3 months.

RESULTS:
The facial profile was symmetry is shape. No facial deformity, nor hypertrophic scar were encountered. There was still mild esotropia (OD) without diplopia at front view, nor EOM limitation noted at the last follow-up in clinic.

CONCLUSIONS:
It is a challenge to radiologists, plastic surgeons and ophthalmologists with regard to both timely diagnosis and surgical management. The outcome is satisfactory in the presented case.

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