Blowout fracture
| Blowout fracture | |
|---|---|
| Classification and external resources | |
 A inferior orbital (blow out) fracture on the persons left |
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| ICD-10 | S02.3 |
A blowout fracture is a fracture of the walls or floor of the orbit. Intraorbital material may be pushed out into one of the paranasal sinuses. This is most commonly caused by blunt trauma of the head, generally personal altercations. Orbital floor fractures were investigated and described by MacKenzie in Paris in 1844[1] and the term blow out fracture was coined in 1957 by Smith & Regan,[2] who were investigating injuries to the orbit and resultant inferior rectus entrapment, by placing a hurling ball on cadaverous orbits and striking it with a mallet. The force of a blow to the orbit is dissipated by a fracture of the surrounding bone, usually the orbital floor and/or the medial orbital wall. Serious consequences of such injury include diplopia in upgaze where there is significant damage to the orbital floor.
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[edit] Causes
Common medical causes of orbital fracture may include:
- Direct orbital blunt injury
- Sports' injury (squash ball, tennis ball etc.)
- Motor vehicle accidents
[edit] Treatment
Surgery is indicated if
- enophthalmos greater than 2mm
- diplopia on primary or inferior gaze
- entrapment of extraocular muscles
- fracture greater than 50% of the orbital floor
When not surgically repaired (for the above indications), most blowout fractures heal spontaneously without significant consequence. Corticosteroid therapy may be used to reduce swelling, and antibiotics administered to cover organisms found in the sinuses.
[edit] References
- ^ Ng P, Chu C, Young N, Soo M. (Aug 1996). "Imaging of orbital floor fractures.". Australas Radiol. 40 (3): 264–268. doi:10.1111/j.1440-1673.1996.tb00400.x. PMID 8826732.
- ^ "Blowout fracture of the orbit: mechanism and correction of internal orbital fracture. By Byron Smith and William F. Regan, Jr". Adv Ophthalmic Plast Reconstr Surg 6: 197–205. 1987. PMID 3331936.
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[edit] External links
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