Orbital Floor Fracture Muscle Entrapment

Entrapment is a purely clinical diagnosis not a radiologic one.

Orbital floor fracture muscle entrapment.

The fracture may spring back into place see trapdoor fracture. Relative indications for surgery are high risk fractures for enophthalmos which involve over one half of the orbital floor or lateral orbital wall. 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. Injury to oculomotor nerve.

Infraorbital anesthesia damage to infraorbital nerve from orbital floor fracture diplopia on upward gaze entrapment of inf rectus or inf oblique or orbital fat. Entrapment requires urgent freeing of the muscle to prevent necrosis of the incarcerated muscle. 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. 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. 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. Isolated orbital floor fracture. 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.

13 use an observation with possible intervention within 1 to 2 weeks in all other cases of confirmed orbital floor fractures. Due to extraocular muscle entrapment. Despite the publication of multiple studies. 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.

Providing information that can be used to help predict enophthalmos and muscle entrapment. For example a fracture might be described as a pure inferior blowout fracture with likely entrapment. Indications for repair of the orbital floor in these cases are the same as those for indirect blowout fractures. Pain with eye movement.

Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim. 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 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. Most fractures occur in the floor posterior and medial.

Periorbital and subconjunctival haemorrhage occur in around 50 of cases. Enophthalmos globe herniation orbital rim step off.