![]() Smaller fractures are associated with a higher risk of entrapment of the nerve and therefore often smaller fracture are more serious injuries. In children, the trapdoor subtype are more common. The most common causes are assault and motor vehicle accidents. The fractures can occur of pure floor, pure medial wall or combined floor and medial wall.They can occur with other injuries such as transfacial Le Fort fractures or zygomaticomaxillary complex fractures. With the trapdoor variant, there is a high frequency of extra-ocular muscle entrapment despite minimal signs of external trauma, a phenomenon that is referred to as a "white-eyed" orbital blowout fracture. In pure orbital blowout fractures, the orbital rim (the most anterior bony margin of the orbit) is preserved, but with impure fractures, the orbital rim is also injured. The hinged orbital blowout fracture is a fracture with an edge of the fractured bone attached on either side. Open door fractures are large, displaced and comminuted, and trapdoor fractures are linear, hinged, and minimally displaced. The two broad categories of blowout fractures are open door and trapdoor fractures. They are characterized by double vision, sunken ocular globes, and loss of sensation of the cheek and upper gums from infraorbital nerve injury. Therefore, medial wall blowout fractures are the second-most common, and superior wall, or roof and lateral wall, blowout fractures are uncommon and rare, respectively. The comparatively thin bone of the floor of the orbit and roof of the maxillary sinus has no support and so the inferior wall collapses mostly. ![]() Although the bone forming the medial wall is the thinnest, it is buttressed by the bone separating the ethmoidal air cells. Most commonly, the inferior orbital wall, or the floor, is likely to collapse, because the bones of the roof and lateral walls are robust. The proximity of maxillary and ethmoidal sinus increases the susceptibility of the floor and medial wall for the orbital blowout fracture in these anatomical sites. Most commonly this results in a herniation of orbital contents through the orbital fractures. Oral & Maxillofacial Surgery, ENT surgery, plastic surgery, ophthalmologyĭouble vision especially when looking up, numbness of the lateral nose skin, the cheek below the eyelid, and the upper lip, Bloody nose, lateral subconjunctival hemorrhage (bright red blood over the sclera (white of the eye))Īn orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall that typically results from the impact of a blunt object larger than the orbital aperture, or eye socket. An orbital blowout fracture of the floor of the left orbit.
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