Orbital Floor Fracture Muscle Entrapment

It is important to remember that diplopia in the setting of orbital floor fractures does not necessarily equate to entrapment of extraocular muscle.

Orbital floor fracture muscle entrapment. Orbital floor fracture also known as blowout fracture of the orbit. The fracture may spring back into place see trapdoor fracture. Especially when the fracture is into an. For example a fracture might be described as a pure inferior blowout fracture with likely entrapment.

Despite the publication of multiple studies. Relative indications for surgery are high risk fractures for enophthalmos which involve over one half of the orbital floor or lateral orbital wall. Providing information that can be used to help predict enophthalmos and muscle entrapment. Orbital blowout fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact.

The most commonly entrapped material following a blowout fracture is orbital fat this alone may lead to decreased up gaze if the orbital floor is involved. Other features to note. Rarely if ever is performing a forced duction test necessary or informative in making the diagnosis of extraocular muscle restriction in an awake patient with. Indications for repair of the orbital floor in these cases are the same as those for indirect blowout fractures.

Enophthalmos globe herniation orbital rim step off. Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim. The most common muscle to be entrapped by the fracture is the inferior rectus muscle. Periorbital and subconjunctival haemorrhage occur in around 50 of cases.

Isolated orbital floor fracture. Entrapment of eye muscle especially in children the inferior rectus muscle is the most common ocular muscle to become entrapped with an orbital floor fracture trap door phenomenon and this may not be visible on conventional x rays. Infraorbital anesthesia damage to infraorbital nerve from orbital floor fracture diplopia on upward gaze entrapment of inf rectus or inf oblique or orbital fat. Pain with eye movement.

Most fractures occur in the floor posterior and medial. Other causes can include direct damage to the extraocular muscles during the injury disruption of motor nerve branches or commonly swelling and hemorrhage within the orbit causing limitation in. Even without a true orbital blowout fracture entrapment of orbital contents enophthalmos and diplopia with restriction of eye movement may occur because of the contributions of the zygomatic bone to the orbital floor. Injury to oculomotor nerve.

Entrapment requires urgent freeing of the muscle to prevent necrosis of the incarcerated muscle. Orbital floor fractures were investigated and described by mackenzie in paris in 1844 and the term blow out fracture was coined in 1957 by smith regan 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.