Orbital blow out fractures

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  • Hello. I would like to use slide number 4 in a book I along with Dr. Steven Snodgrass are writing on trauma. How can we obtain permissive use for our book. Thank you. Frank Williams Ph.D.
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Orbital blow out fractures

  1. 1. ORBITAL BLOW-OUT FRACTURES KEERTHI N S 2010 BATCH
  2. 2.  Are isolated comminuted fractures that occur when the orbital walls are pressed indirectly  Mainly involve floor and medial wall
  3. 3. ETIOLOGY  Trauma by BLUNT OBJECTS like  Tennis ball  Cricket ball  Human fist  Part of automobiles
  4. 4. MECHANISM OF FRACTURE  Force of blow  backward displacement of eyeball  intraorbital pressure increases  fracture in the weakest point of orbital wall
  5. 5. CLASSIFICATION  1. PURE BLOW-OUT FRACTURES  2. IMPURE BLOW-OUT FRACTURES
  6. 6. EFFECTS OF ORBITAL FLOOR FRACTURE
  7. 7. 1. Herniation of orbital contents
  8. 8. 2. Entrapment of inferior rectus
  9. 9. 3. Damage to infraorbital nerve
  10. 10. CLINICAL FEATURES
  11. 11.  Pain  Diplopia  Epistasis
  12. 12. SIGNS EARLY SIGNS  Peri orbital ecchymosis  Emphysema of lids  Paraesthesia and anaesthesia  Ipsilateral epistasis  Proptosis LATE SIGNS  Enopthalmos and mechanical ptosis  Diplopia
  13. 13. X ray CT MRI ORBITAL IMAGING
  14. 14. Plain X rays  Water’s view  Findings:  Fragmentation and irregularity of orbital floor  Hanging drop opacity
  15. 15. Coronal Computerised tomography  CTs are diagnostic method of choice  Coronals provide best view  CT can show  Herniation of fat into maxillary sinus
  16. 16.  Magnetic resonance imaging  extraocular muscle rounding
  17. 17. MANAGEMENT General measures and medical:  Avoid nasal blowing  Systemic antibiotics  Analgesis  Anti inflammatory drugs  Cold compresses
  18. 18. Surgical management  Indications:-  Diplopia not resolving  Large herniation of tissues to antrum  Retracted globe and applanation tension  Enophthalmos  Aim:  To restore the continuity of floor with or without implants(silicone rubber layer)  Time:  After 10-14 days of injury

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