Orbital Floor Fracture Muscle Entrapment

It is important to remember that diplopia in the setting of orbital floor fractures does not necessarily equate to entrapment of extraocular muscle.

Orbital floor fracture muscle entrapment.

Injury to oculomotor nerve. The most common muscle to be entrapped by the fracture is the inferior rectus muscle. Other causes can include direct damage to the extraocular muscles during the injury disruption of motor nerve branches or commonly swelling and hemorrhage within the orbit causing limitation in. Providing information that can be used to help predict enophthalmos and muscle entrapment.

Isolated orbital floor fracture. Periorbital and subconjunctival haemorrhage occur in around 50 of cases. Most fractures occur in the floor posterior and medial. Infraorbital anesthesia damage to infraorbital nerve from orbital floor fracture diplopia on upward gaze entrapment of inf rectus or inf oblique or orbital fat.

Relative indications for surgery are high risk fractures for enophthalmos which involve over one half of the orbital floor or lateral orbital wall. Despite the publication of multiple studies. Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim. Other features to note.

Entrapment is a purely clinical diagnosis not a radiologic one. The fracture may spring back into place see trapdoor fracture. Even without a true orbital blowout fracture entrapment of orbital contents enophthalmos and diplopia with restriction of eye movement may occur because of the contributions of the zygomatic bone to the orbital floor. Enophthalmos globe herniation orbital rim step off.

Pain with eye movement. For example a fracture might be described as a pure inferior blowout fracture with likely entrapment. Orbital blowout fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact. Due to extraocular muscle entrapment.

Entrapment of eye muscle especially in children the inferior rectus muscle is the most common ocular muscle to become entrapped with an orbital floor fracture trap door phenomenon and this may not be visible on conventional x rays. Rarely if ever is performing a forced duction test necessary or informative in making the diagnosis of extraocular muscle restriction in an awake patient with. 13 use an observation with possible intervention within 1 to 2 weeks in all other cases of confirmed orbital floor fractures. Orbital floor fracture also known as blowout fracture of the orbit.

The most commonly entrapped material following a blowout fracture is orbital fat this alone may lead to decreased up gaze if the orbital floor is involved. Entrapment requires urgent freeing of the muscle to prevent necrosis of the incarcerated muscle.