Orbital Floor Fracture Muscle Entrapment

Orbital blowout fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact.

Orbital floor fracture muscle entrapment.

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. Providing information that can be used to help predict enophthalmos and muscle entrapment. Entrapment requires urgent freeing of the muscle to prevent necrosis of the incarcerated muscle. The most common muscle to be entrapped by the fracture is the inferior rectus muscle.

Orbital floor fracture also known as blowout fracture of the orbit. 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. Relative indications for surgery are high risk fractures for enophthalmos which involve over one half of the orbital floor or lateral orbital wall. Injury to oculomotor nerve.

Especially when the fracture is into an. Due to extraocular muscle entrapment. 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. 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.

Periorbital and subconjunctival haemorrhage occur in around 50 of cases. Despite the publication of multiple studies. Pain with eye movement. Other features to note.

Isolated orbital floor fracture. For example a fracture might be described as a pure inferior blowout fracture with likely entrapment. Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim. Most fractures occur in the floor posterior and medial.

13 use an observation with possible intervention within 1 to 2 weeks in all other cases of confirmed orbital floor fractures. It is important to remember that diplopia in the setting of orbital floor fractures does not necessarily equate to entrapment of extraocular muscle. The fracture may spring back into place see trapdoor fracture. 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. Infraorbital anesthesia damage to infraorbital nerve from orbital floor fracture diplopia on upward gaze entrapment of inf rectus or inf oblique or orbital fat.