Management of orbital blow-out fractures

Abstract

Two main patterns of orbital fractures are encountered: zygomaticomaxillary complex (ZMC) fractures and isolated orbital fractures. ZMC fractures, also known as tripod fractures, are frequently caused by a direct trauma to the zygomatic bone (e.g., with a fist, or a baseball bat) and are characterized by multiple fractures involving the inferior orbital rim, the zygomatic arch, the frontozygomatic suture and the zygomaticomaxillary suture; the orbital floor is frequently involved during ZMC fractures. The management of a tripod fracture is complex, requires a multidisciplinary approach and it is not the goal of this perspective. Isolated orbital fractures, also known as blow-out fractures, are internal fractures of the orbital floor and/or medial wall, with displacement of orbital soft tissues (fat and/or muscle) in the adjacent sinuses. This paper will focus on the pathophysiology, diagnosis and management of orbital blow-out fractures.