Orbital blow-in fracture

Case contributed by Shervin Sharifkashani
Diagnosis certain

Presentation

Left side facial trauma one week ago. Left eye proptosis, upward gaze limitation, and hypoglobus at present.

Patient Data

Age: 10 years
Gender: Female
ct

Displaced comminuted blow-in fracture in the left orbital roof with subperiosteal hematoma measuring 8 x 15 x 23 mm (CC x ML x AP) in the middle-to-nasal side of the orbital roof and with pronounced impression on the related extraocular muscles and proptosis.

Case Discussion

The orbital roof blow-in fracture is relatively uncommon, more commonly seen in children, and must be considered as a base of skull fracture. It can be complicated by CSF leakage and/or intracranial hemorrhage and/or intraorbital hemorrhage. The proptosis can be due to decreased volume of the orbital cavity or the impression of displaced bone and/or subperiosteal hematoma in the orbital roof, as in this particular case, on the related extraocular muscle or the eye globe.

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