![]() Alternatively, the trauma may be directed towards the orbital rim, which then leads to a bending of the orbital walls with consequent fracturing (buckling mechanism). The trauma mechanism is a blunt, directed force that may be aimed at the eye without a pressure component toward the eye rim, leading to an increase of pressure inside the orbit with a fracture of the bony structures (a hydraulic mechanism). The common mechanisms are falls, high-velocity ball-related sports, traffic accidents, and interpersonal violence. EtiologyĪ blowout fracture is an isolated fracture of the orbital walls without compromise of the orbital rims. While some cases may be managed with conservative care, others may require some type of surgical intervention. Finally, the orbital injury can lead to retinal edema, hyphema, and significant loss of vision. In addition, the orbital tissue and inferior rectus muscle can become trapped by the bony fragments leading to diplopia, limitation of gaze, and tethering. The problem with orbital blowout fractures is that the volume of the orbit can be increased, resulting in enophthalmos and hypoglobus. The goal of treatment is to restore aesthetics and physiological function. The fat and connective tissue around the globe help to reduce the pressure exerted by the extraocular muscles. Located around the globe of the eye and attached to it are 6 extraocular muscles the 4 rectus muscles and the superior and inferior oblique muscles. Superior and inferior borders are the frontal and maxillary bones. The zygomatic bone forms the lateral wall. Lateral to the orbital canal lies the superior orbital fissure housing cranial nerves III, IV, V, and VI. The sphenoid bone forms the posterior wall and houses the orbital canal. Together with the lamina papyracea of the ethmoid bone, they form the medial wall. Medially, the maxillary and the lacrimal bone form the lacrimal fossa. The frontal, ethmoidal, sphenoid, zygomatic, and lacrimal bones form the bony structures of the orbit. Knowledge of anatomy is mandatory when dealing with patients presenting with trauma to the orbit. Orbital fractures have a distinct trauma mechanism and are complex due to the complex anatomy of the bony and soft tissue structures involved. Summarize the role of improving coordination among the interprofessional team to streamline diagnosis and treatment for patients with orbital floor fracture.įractures of the orbital floor and the medial orbital wall (blowout fractures) are common midface injuries.Describe the treatment and management of orbital floor fractures, including potential complications after initial treatment or surgery.Review the procedure for a proper history and physical examination to address a potential orbital floor fracture, including potential differentials.Outline the osseous anatomy of the orbit of the eye.This activity reviews the etiology, presentation, evaluation, and management of fractures of the orbital floor and reviews the role of the interprofessional team in evaluating, diagnosing, and managing the condition. Fractures of the orbital floor and the medial orbital wall (blowout fractures) are common midface injuries.
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