Orbital Floor Fracture Muscle Entrapment

Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim.

Orbital floor fracture muscle entrapment.

13 use an observation with possible intervention within 1 to 2 weeks in all other cases of confirmed orbital floor fractures. Infraorbital anesthesia damage to infraorbital nerve from orbital floor fracture diplopia on upward gaze entrapment of inf rectus or inf oblique or orbital fat. Providing information that can be used to help predict enophthalmos and muscle entrapment. Enophthalmos globe herniation orbital rim step off.

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. Isolated orbital floor fracture. Especially when the fracture is into an. Entrapment requires urgent freeing of the muscle to prevent necrosis of the incarcerated muscle.

Injury to oculomotor nerve. Orbital floor fracture also known as blowout fracture of the orbit. The most common muscle to be entrapped by the fracture is the inferior rectus muscle. For example a fracture might be described as a pure inferior blowout fracture with likely entrapment.

Pain with eye movement. Orbital blowout fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact. Indications for repair of the orbital floor in these cases are the same as those for indirect blowout fractures. 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.

Other features to note. Most fractures occur in the floor posterior and medial. 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. Relative indications for surgery are high risk fractures for enophthalmos which involve over one half of the orbital floor or lateral orbital wall.

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. Periorbital and subconjunctival haemorrhage occur in around 50 of cases. 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. Despite the publication of multiple studies.

Entrapment is a purely clinical diagnosis not a radiologic one. Due to extraocular muscle entrapment.