Download - Orbital blow out fractures
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ORBITAL BLOW-OUT FRACTURES
KEERTHI N S
2010 BATCH
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Are isolated comminuted fractures that occur when the orbital walls are pressed indirectly
Mainly involve floor and medial wall
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ETIOLOGY
Trauma by BLUNT OBJECTS like Tennis ball Cricket ball Human fist Part of automobiles
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MECHANISM OF FRACTURE
Force of blow backward displacement of eyeball intraorbital pressure increases fracture in the weakest point of orbital wall
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CLASSIFICATION
1. PURE BLOW-OUT FRACTURES
2. IMPURE BLOW-OUT FRACTURES
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EFFECTS OF ORBITAL FLOOR FRACTURE
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1. Herniation of orbital contents
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2. Entrapment of inferior rectus
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3. Damage to infraorbital nerve
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CLINICAL FEATURES
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Pain Diplopia Epistasis
SYMPTOMS
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SIGNS
EARLY SIGNS Peri orbital ecchymosis Emphysema of lids Paraesthesia and anaesthesia Ipsilateral epistasis Proptosis
LATE SIGNS Enopthalmos and mechanical ptosis Diplopia
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X rayCTMRI
ORBITAL IMAGING
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Plain X rays
Water’s view
Findings: Fragmentation and
irregularity of orbital floor
Hanging drop opacity
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Coronal Computerised tomography
CTs are diagnostic method of choice
Coronals provide best view CT can show
Herniation of fat into maxillary sinus
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Magnetic resonance imaging
extraocular muscle rounding
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MANAGEMENT
General measures and medical:
Avoid nasal blowing Systemic antibiotics Analgesis Anti inflammatory drugs Cold compresses
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Surgical management
Indications:- Diplopia not resolving Large herniation of
tissues to antrum Retracted globe and
applanation tension Enophthalmos
Aim: To restore the continuity
of floor with or without implants(silicone rubber layer)
Time: After 10-14 days of injury
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