Orbital Blowout Fx!

Medial Blowout Fx Inferior Blowout Fx

http://radiopaedia.org/articles/blow-out_fracture

Orbital blowout fx are usually the result of blunt force trauma to the orbital rim. Examples of this type of trauma would be contact with a baseball, a baseball bat, MVA, and a fist. In an orbital fx, the blunt force "blows" out the floor or adjacent wall of the rim of the orbit. In most cases, it usually occurs in the inferior floor of the orbit, or the medial wall of the orbit. Also, the nasal bones are usually broken as well especially when the blowout fx involves the medial wall of the orbit.

Symptoms of an Orbital Blowout Fx are:

Pain

Diplopia on an upward stare - related to involvement on orbital muscles.

Enophthalmos - related to increased swelling and preasure in the orbital globe.

Facial numbness - related to inferior orbital nerve

Nose bleed

Orbital hemorrhage may occur

Imaging the Orbits

CT with coronals and axials specifically.

MRI with coronals and axials specifically, be sure to use fat suppression technique during exam.

Xray in the waters position especially.

Tx for Orbital Blowout Fx

Surgical repair of orbital blowout fx when:

More than 1/2 of the orbit floor or wall is invovled

Diplopia does not quickly resolve itself

Enophthalmos >2mm

Surgical repair usually involved a form of bone graft, synthetic material, or plate to fix the hole in the orbital rim.

Orbital blowout fx that go untreated, and have significant obital muscle, optic nerve, and acute bone damage can lead to long term visual defects as well as enophthalmos.

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