Presentation
35-year-old man in ED for two men aggression with a glass bottle. The patient wasn't able to see with his right eye.
Patient Data
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Head CT was performed after initial clinical examination.
CT findings:
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.
Patient was immediately admitted to OR.
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
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