Orbital Floor Fracture Without Entrapment

Orbital floor fractures off with entrapment require prompt clinical and radiographic recognition for timely surgical correction.

Orbital floor fracture without entrapment. Lateral to the orbital canal lies the superior orbital fissure housing cranial nerves iii iv v and vi. The most commonly entrapped material following a blowout fracture is orbital fat this alone may lead to decreased up gaze if the orbital floor is involved. It is estimated that about 10 of all facial fractures are isolated orbital wall fractures the majority of these being the orbital floor and that 30 40 of all facial fractures involve the orbit. Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim.

Conversely a large orbital floor and medial wall fracture in an older patient is infrequently associated with an exaggerated ocr. Fractures of the orbital floor are common. Depending on the location and mechanism intracranial thoracic and abdominal injuries may be associated. A second level of differentiation is between blowout fractures with or without entrapment of orbital contents.

We reviewed the clinical radiographic and intraoperative findings of 45 cases of entrapped off to correlate pre and. Fracture of the orbital floor also known as a blow out fracture can result in entrapment of the inferior rectus muscle limiting upward gaze. Correct ct radiographic interpretation of entrapped fractures can be subtle and thus missed. A case is described involving a patient in his fifth decade with a pronounced ocr as a result of a large orbital floor and medial orbital wall fracture without inferior rectus or medial rectus muscle entrapment.

Orbital blowout fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact. This is typically caused by a direct blow to the central orbit from a fist or ball. Ophthalmologists most often get involved in pure orbital fractures with an intact orbital rim and without other facial bone fracture. The anatomy of the orbital floor predisposes it to fracture.

An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall typically resulting from impact of a blunt object larger than the orbital aperture or eye socket. The zygomatic bone forms the lateral wall. By contrast open door fractures which are much more prevalent in adults are comminuted creating a large orbital floor defect that allows herniation without entrapment 3differences in these fracture patterns are attributable to differences in bone characteristics between children and adults.