Orbital blow-in fractures

Orbital blow-in fractures are characterized by an inferior displaced injury of the roof of the orbit, usually due to a sudden traumatic-induced increase in intracranial pressure.

Clinical presentation

Complications

• orbital blow-in fractures are associated with intraorbital injuries
  • extraocular muscle entrapment
  • optic nerve injury
  • intracranial hemorrhage/hematoma contusions

Pathology

A blow-in fracture reduces the volume of the orbit resulting in acute traumatic injury of the intraorbital contents. 

Usually blow-in fractures are impure, i.e. they occur in conjunction with other facial bone fractures, such as supraorbital rim and frontal sinus fractures. More rarely, are so-called pure blow-in fractures, in which the injury is restricted to the orbital roof.

Radiographic features

• CT is the modality of choice for diagnosis and choice of appropriate (surgical or conservative) treatment for orbital blow in fractures
• sagittal and coronal reformats are the optimal planes for assessment of orbital blow-in fractures

Treatment and prognosis

If blow-in fractures are associated with significant bone displacement, then surgical orbital decompression is usually performed.

See also

• orbital blow-out fractures
• orbital fractures
• facial bone fractures