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Orbital blow-in fractures

Last revised by Dr Daniel J Bell on 03 Aug 2022

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.

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.

  • 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

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

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