Abstract
The orbit is made up of seven bones, of which, the inferior wall is most vulnerable to injury and the lateral wall, the least common. In assessing facial trauma, it is crucial to include a comprehensive examination and to manage the orbital fractures accordingly. Orbital floor fracture may present with enophthalmos, diplopia and inferior orbital neuropathy. The infra-orbital rim may show a step-off deformity. Full ophthalmologic evaluation is important to rule out optic nerve neuropathy, retinal bleed, and corneal abrasion. Fracture extending to the superior orbital fissure is known as the superior orbital fissure syndrome, often presented with third, fourth and sixth cranial nerves dysfunction. Orbital roof fracture may involve the frontal lobe and frontal sinus. Fracture involving the naso-orbital ethmoid complex may present with CSF leak, diplopia, displaced medial canthus and nasal fracture. High-resolution 1.5mm CT scans is most useful in the aid of diagnosis in addition to tomography. Displaced fractures should be corrected surgically before bony union. Two examples of complex orbital fractures will be presented, illustrating the importance of a multi-surgical team approach to achieve the optimum results.
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