Orbital blow out fracture

Case contributed by Dr Heather Pascoe


Found face down on concrete.

Patient Data

Age: 80
Gender: Female

Brain and Facial Bones


  • Left frontal scalp haematoma extending into the lateral periorbital soft tissues.
  • No intracranial haemorrhage.

Facial Bones

  • Left periorbital haematoma.
  • Blow out fracture of the left orbital floor and lamina papyracea with involvement of the infraorbital nerve and entrapment of orbital fat. Inferior oblique is also displaced inferiorly. 
  • Numerous gas locules seen within the orbital soft tissues.
  • Mildly depressed left medial orbital wall fracture with opacification of the adjacent ethmoid air cells.
  • Undisplaced fracture through the left zygoma.
  • Minimally displaced nasal bone fracture, deviated to the right.

Case Discussion

There are two broad categories of blow-out fractures. Open door fractures (seen in this case) are a large and displaced fracture and are frequently comminuted. Trap door fractures are linear and hinged and minimally displaced. Trap door fractures typically occur in the paediatric population and have a high incidence of extra-ocular muscle entrapment. Other facial bone fractures are commonly present when there is an orbital fracture.

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Case information

rID: 32864
Published: 9th Feb 2018
Last edited: 13th Aug 2018
Inclusion in quiz mode: Included

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