Blow-out Fracture Flashcards
Definition
It’s a fracture of the orbital floor due to blunt trauma
What is the most common orbital fracture
Blow-out fracture
What is the mechanism
Not important
But, it is due to ++ of intra-orbital pressure, which leads to a fracture of orbital floor
Someone stuck with John Cena and got punched in the eye, then came to the ER. How do you know he had a fractured orbital floor?
Triple H, just kidding..
periocular signs
True Endophthalmos
Binocular diplopia
cheek anesthesia
Rarly intraocular damage
Now, what are periocular signs
Black eye
Edema
Subcutaneous emphysema
Cheek anesthesia due to:
Injury to the infraorbital nerve
Why diplopia and which type
Impingement of the inferior rectus or may be inferior oblique can resule in vertical diplopia (worse in upward gaze)
What are the investigations that you can request them
CT
MRI: best to avoid it ( You don’t know what he was hit with)
Orbital X-Ray
Hess test
Now a question (علي أساس ما نسألش من بدري)
Is blow-out fracture an orbital emergency?
No, it doesn’t need an immediate intervention except for severe cases
What is the treatment
Surgery
When you should do the surgery
In case of enophthamos or diplopia
Surgery consist of:
Exploration and repositioning of bone
release of trapped tissues
Covering of fracture site with synthetic material (silicon or metallic mesh)
