Blowout Fracture of the Orbit

Blowout fractures of the orbit are fractures of the orbital wall that are caused by trauma to the orbit. There are a variety of different locations that orbital fractures can occur depending on the force and location of the direct blow. "Buckling" and "Retropulsion" are the two ways to describe what happens to cause an blowout fracture. With the idea of "buckling", the orbital floor fractures due to the buckling of the orbital rim and the transferred pressure to the orbital wall. The idea behind "retropulsion" is that the trauma causes an increased pressure within the orbital cavity, which results in a fracture. Blowout fractures are the result of "retropulsion". These most commonly occur in the floor of the orbit, but cal also occur in the medial wall of the orbit. They are caused by a direct blow to the orbit by an object that is larger in diameter than the orbital socket itself. Naso-orbital fractures also occur from a direct blow, but from an object smaller than the diameter of the orbit. These fractures typically occur to the medial wall in combination with the nasal bones and ethmoid sinus. CT imaging is used to best visualize the location on the fracture. A coronal image is shown above with a orbital floor fracture. Surgery is primarily the only way to treat blowout fractures, because of the location and severity of the fracture they are not likely to heal on their own.