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(Orbital) Blowout Fracture (Defined)
American Association for Pediatric Ophthalmology and Strabismus ^ | updated 07/2013 | AAPOS

Posted on 08/19/2014 10:24:38 AM PDT by smoothsailing

American Association for Pediatric Ophthalmology and Strabismus

July 2013

Blowout Fracture

What is a “blowout” fracture?

A blowout fracture is a fracture of one or more of the bones surrounding the eye and is commonly referred to as an orbital floor fracture.

What is the orbit?

The orbit consists of the bones surrounding the eye. When looking at a skull, the orbit is the hole in the skull encompassing the eye.

What is the “floor” of the orbit?

The bones on the bottom of the orbit are the floor. The bones on the top are the roof and the bones on the side are the walls.

What is the function of the orbit?

The orbit holds the eye in the correct position. The orbit also protects the eye. Because the bones surrounding the eye “stick out” further than the eye, objects tend to hit the orbit and not the eye.

What causes a blowout fracture?

Blowout fractures result from trauma to the orbital bones. When an object hits the orbital bones (usually the eye brow and upper cheek bone) the force is transmitted to the bones. If the force is great enough, the bones buckle and break.

What are common causes of blowout fractures?

Any large object with force or speed can cause a blowout fracture. Typical causes include motor vehicle accidents, balls used in sports, fists, and elbows.

What are the symptoms of an orbital blowout fracture?

The most common symptoms are bruising, tenderness and swelling around the eye; redness of the eye; double vision, ordiplopia (seeing two images at the same time); numbness of the cheek, nose or teeth; nose bleeds (epistaxis) [See figure 1].

Symptoms that typically indicate a more serious injury are pain on eye movement, double vision, air under the skin around the eye, and numbness of the cheek/mouth/nose on the side of the injury. Severe trauma may cause facial bone fractures, injury to the eye itself, and injuries to the skull/brain.

How do you know if there is a fracture?

X-rays and CT scans of the orbit and face are used to make the diagnosis [See figure 2].

Are there different types of blowout fractures?

Blowout fractures are classified on several features including:

• size (big or small)
• location (front or back)
• bone in place or displaced
• tissue/muscle entrapped in fracture
• accompanying symptoms (double vision, pain, eye position)

A “simple” fracture is one with minimal or no double vision, minimal or no interference with eye movements, and minimal fracture size.

What can be done for a simple blowout fracture?
Most simple blowout fractures usually heal without lasting problems. Treatment consists of:

• ice to decrease swelling
• decongestants to aid in the drainage of blood and fluid accumulating in the sinuses
• avoidance of nose blowing to prevent pressure from propelling the sinus contents into the orbit
• oral steroids in some cases to decrease swelling and scarring
• sometimes oral antibiotics

When should surgical repair of blowout fractures be considered?

Fractures with persistent symptoms (typically double vision or pain) are usually candidates for surgical repair. Timing of the repair varies, but most often is within two weeks of the injury. Initial repair may consist of any of the following:

• exploration of fracture site and repositioning of bone
• release of trapped tissue from fracture site
• covering of fracture site with synthetic material

What long-term problems may develop following blowout fractures?

Most fractures heal without long-term effects. However, strabismus surgery (eye muscle surgery) is sometimes necessary for persistent double vision. Occasionally, persistent double vision can be treated with non-surgical methods (prism glasses or botulinum toxin injections).

 updated 07/2013


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To: ButThreeLeftsDo

If it went down as the officer and other witnesses are saying this was a righteous shoot if I were on the jury.


21 posted on 08/19/2014 11:43:01 AM PDT by sarge83
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To: sarge83

The problem has been, all along, that the race-baiters and the out of town thugs have hampered the ability of authorities to do a complete and thorough investigation. Eventually, the facts will solve this and the cop is exonerated.


22 posted on 08/19/2014 11:45:56 AM PDT by ButThreeLeftsDo (Please $upport Free Republic.)
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To: Kenny Bunk

Not sure about life-threatening, but it can definitely lead to the loss of the eye.


23 posted on 08/19/2014 12:14:11 PM PDT by DeltaZulu
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To: smoothsailing

He punched himself afterward to make it look like self defense. /s


24 posted on 08/19/2014 12:37:47 PM PDT by informavoracious (Open your eyes, people!)
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To: rktman

or perhaps the giant tried to play the knockout game


25 posted on 08/19/2014 12:41:08 PM PDT by bert ((K.E.; N.P.; GOPc.;+12 ..... Obama is public enemy #1)
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To: pas
why not release this information immediately

Because the ptb wanted to set the narrative first. THANK GOD some locals went rogue and released the video of the robbery/assault and now about the officer's injuries.

Blacks and their enablers have been played. Was it supposed to be a way to take attention away from the hordes of Central Americans enabled to invade the US?

Has any government ever before in history deliberately destroyed its own nation?

26 posted on 08/19/2014 12:48:29 PM PDT by grania
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To: smoothsailing

What are common causes of blowout fractures?
...fists, and elbows.

The gentle giant wasn’t so gentle.


27 posted on 08/19/2014 12:53:33 PM PDT by 1Old Pro
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To: SamuraiScot

Uh. You are wrong. The floor and medial wall of the orbit is paper thin ( lamina papyracea in Latin). That’s what breaks in an orbital floor blowout fracture. The only way it might be fatal is if you got an infection that tracked into the CNS.

Now any blow to the head, in the right circumstance could lead to an intracranial hemorrhage. But that’s not directly associated with an orbital blow out fx.


28 posted on 08/19/2014 1:01:29 PM PDT by Kozak ("It may be dangerous to be America's enemy, but to be America's friend is fatal" Henry Kissinger)
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To: SamuraiScot

A brain concussion is totally different from an orbital blowout. Even so, I never heard of someone being killed by a concussion alone.


29 posted on 08/19/2014 2:14:35 PM PDT by Kirkwood (Zombie Hunter)
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To: Kozak; Kirkwood
How will it kill you?

Gents, I'm not really sure what point this is about. If someone or something hits you hard enough there to break the bone, you have been hit very hard indeed. That event can kill you. In practical terms, the cheekbone is massive, the brow is massive, and if someone has managed to break into that shark cage and break the orbital, you're in big trouble for a lot of reasons. It doesn't matter if your death is directly associated with the orbital break or not. The concussion you may get from the blow itself could be enough to kill you; the force to the back of your head if you fall down could be enough.

Meanwhile, the very fact that something between the fist and your brain is breaking and thereby absorbing shock could actually reduce the force reaching your brain case. But even so, it's often not enough, because people often die from these events. The knock-out "game" comes to mind.

30 posted on 08/19/2014 3:21:01 PM PDT by SamuraiScot
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To: Fido969

This is part of why obammy isn’t running hard with this thing. He has to say something or his base will crucify him.... but he knows the bottom line here.


31 posted on 08/19/2014 3:23:24 PM PDT by kjam22 (my music video "If My People" at https://www.youtube.com/watch?v=74b20RjILy4)
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To: SamuraiScot

Look here’s why you are wrong. The reason the orbital floor fractures is because the eye is liquid and nor compressible. Putting pressure on the eyeball with a fist can cause that paper thin bone to fracture . You don’t have to break through the cheek or brow ridge to do it. I’ve seen literally dozens of blow out fractures in my 30 years of ER practice, and very rarely are they associated with a significant concussion. One good punch to the eye can do it.


32 posted on 08/19/2014 7:09:33 PM PDT by Kozak ("It may be dangerous to be America's enemy, but to be America's friend is fatal" Henry Kissinger)
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To: SamuraiScot

I’ve never heard of anyone dying from an orbital blowout. The blowout is ordinarily into the frontal or maxillary sinus space. Traumatic optic neuropathy is certainly a possibility whenever concussive forces become concentrated at the orbital apex and trap the optic nerve. But no one has ever died from a TON to my knowledge. I’m just asking for some evidence of someone ever dying from an orbital fracture because that claim was made here.


33 posted on 08/19/2014 7:43:33 PM PDT by Kirkwood (Zombie Hunter)
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To: Kozak; Kirkwood

Y’all are just answering a different question, that’s all.


34 posted on 08/20/2014 6:27:30 AM PDT by SamuraiScot
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