Superior orbital fracture

Case contributed by Giovanni Rinaldi
Diagnosis certain


Two man fight with a glass bottle. The patient wasn't able to see with his right eye.

Patient Data

Age: 35 years
Gender: Male

Right frontal sinus compound fracture with gas bubble and blood collection within.

Fracture of the right orbital roof with displacement of bony fragments into the orbital cavity.

Nasal bone fracture.

Right globe fracture with palpebral soft tissue swelling.

Case Discussion

Orbital fractures:

  • Blow-out:  direct trauma on ocular bulb with trauma transmission on medial wall (50% of cases) and floor of the orbit (25%).

  • Blow-in:  indirect trauma on frontal or temporo-frontal bone. Traumatic energy is transmitted to the orbital roof or lateral wall.

Clinical examination:

  • usually very complex

  • enophthalmos

  • ocular motility disorders

  • ocular hemorrhage and swelling

  • nosebleed

This patient was immediately admitted to the OR.

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