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Fracture, Blow Out, Sports Medicine

Giselle Aerni, MD and Robert L. Howard, MA, ATC Reviewed 04/2019
 


BASICS

DESCRIPTION

Defined as an orbital floor or medial wall fracture without orbital rim involvement owing to blunt trauma to the orbit 

EPIDEMIOLOGY

  • Sport-related injury accounts for 1/3 of all orbita...

DIAGNOSIS

HISTORY

  • Mechanism of injury: significant trauma to the orbit

  • Pain

  • Swelling

  • Bruising

  • Double vision with upward gaze

PHYSICAL EXAM

  • Periorbital tenderness, swelling, ecchymosis

  • Impaired ocular mobility...

TREATMENT

GENERAL MEASURES

  • Apply cool compresses for the first 24 to 48 hr to decrease swelling in order to minimize/reverse herniation and avoid surgical intervention.

  • Avoid Valsalva maneuvers and nose...

ONGOING CARE

COMPLICATIONS

  • Sinusitis

  • Orbital infection

  • Permanent restriction of extraocular movement

  • Enophthalmos

  • Decreased visual acuity

REFERENCES

1
Chung SY, Langer PD. Pediatric orbital blowout fractures. Curr Opin Ophthalmol.  2017;28(5):470–476.
2
Cellina M, Floridi C, Panzeri M, et al. The role of computed tomography (CT) in pr...

ADDITIONAL READING

  • Aerni GA. Blunt visual trauma. Clin Sports Med.  2013;32(2):289–301.

  • Jones NP. Orbital blowout fractures in sport. Br J Sports Med.  1994;28(4):272–275.

  • Lincoln AE, Caswell ...

CLINICAL PEARLS

  • Pediatric patients >5 yr old are more likely to have trapdoor fractures which require immediate surgical intervention.

  • CT scan of the orbits is the diagnostic test of choice.

  • Most orb...

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