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Orbital blow-out fracture

Case contributed by Shervin Sharifkashani
Diagnosis certain

Presentation

Facial trauma and right eye pain and upward gaze limitation.

Patient Data

Age: 10 years
Gender: Female
ct

Right orbital floor Blow-out fracture with orbital fat and inferior rectus muscle prolapse within the fracture gap and minimally displaced fracture in the medial wall more clearly seen on axial images and hemorrhage within the right side maxillary and ethmoid sinus are seen. Caudally stretched medial rectus muscle toward the floor fracture is seen. A few small foci of retrobulbar hemorrhage and preseptal and lacrimal gland soft tissue swelling are noted. Mild exodeviation of the right eye is also seen.

Case Discussion

The case illustrates the pronounced hernia of the inferior rectus muscle and orbital fat within the orbital floor blow-out fracture gap which has led to upward gaze limitation of the eye that is the indication for surgical repair. The blow-out fractures can lead to enophthalmos, diplopia, and in children amblyopia. On the other hand, the long-standing extraocular muscle entrapment leads to muscle ischemia and necrosis and permanent muscle dysmotility and diplopia.

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