$orbital fracture$

$orbital fracture$

For fractures with significant enophthalmos, thicker barrier channel porous polyethylene is used. For isolated orbital floor fractures, our preferred implants are thin porous polyethylene sheets or nylon foil. Our preference for implant choice depends on the location and amount of enophthalmos. The zygoma is fractured along the fronto-zygomatic, zygomatic-maxillary, and zygomatic-temporal suture lines with possible soft tissue entrapment. Tripod fractures can also be associated with orbital floor fractures but with a different mechanism.

$orbital fracture$

Repair is typically via a transconjunctival approach with complete reduction of the orbital contents from the fracture site and placement of an alloplastic implant. Other indications vary but most surgeons will repair fractures within 2 weeks if one or more of the following criteria are met: diplopia within 30° of primary gaze associated with a positive forced duction test, clinically significant enophthalmos greater than 2 mm, and a fracture size greater than 50% of the orbital floor. Urgent indications for fracture repair include the “white-eyed” blow out fracture in children where the fracture site incarcerates the rectus muscle causing possible ischemia, and the oculocardiac reflex resulting from muscle entrapment. CT imaging with axial and coronal thin cuts is essential for diagnosis, treatment and decision making in fracture repair. Symptoms may include diplopia from entrapment of the inferior rectus muscle, enophthalmos, infraorbital nerve hypesthesia, and hypoglobus. Two theories are postulated: (1) the indirect hydraulic theory in which posterior pressure in the orbit causes a blow-out and (2) the direct buckling theory in which direct pressure along the inferior orbital rim causes deformation along the floor. Orbital apex fractures involving the optic canal may result in optic neuropathy with vision loss.īlow-out fractures occur when an object strikes the orbital entrance. Other fractures include zygomaticomaxillary complex (tripod) fractures, Le Fort fractures, and nasoethmoidal fractures. Several types of fractures involve the orbit with blow-out fractures being the most common. Fractures comprise the majority of bone injuries. The clinical presentation and treatment vary, based on the cause, findings, and symptoms. Rule out globe injury perform dilated fundoscopic examīony and soft tissue injury can occur with any trauma to the orbit. Vital signs – heart rate, blood pressure history of nausea/lightheadedness from oculocardiac reflex Palpation for bony step off, trismus and signs of zygomaticomaxillary complex fracture (tripod) Extraocular muscle movements and primary deviationĬT scan, axial and coronal views with thin cuts

$orbital fracture$

Orbital fracture