Clinical Analysis of Blow-In Orbit Fracture and Its Treatment

Sung, Kun Yong; Jun, Myung Gon; Ahn, Hee Chang

Abstract

Blow-in orbit fracture is relatively rare fracture which is an inward displacement of the orbital rim or wall fragment, resulting in decreased orbital volume. The objective of this article is to analyze blow-in fracture status of orbit and to suggest appropriate management in this unusual fracture. The study included 23 cases who had treatment of blow-in fractures of orbit from July, 1995 to June, 2001. Their ages ranged from 4 years to 63 years. There were 17 males and 6 females. The diagnosis of blow-in fracture was accomplished with physical examination, ophthalmologic examination, plain X-ray, and facial CT scan. According to Antonyshyn's classification, we classified them into 2 large groups which were pure type and impure type. Pure type blow-in fractures are relatively uncommon and 5 cases were documented in a series of 23 patients. Impure type fractures included the orbital rim and 18 cases were documented. Clinical symptoms of blow-in fractures were proptosis, limitation of eyeball movement, diplopia, blepharoptosis, subconjunctival hemorrage and blindness. 2 patients with globe rupture and blindness underwent enucleation due to direct injury by bony segment. We conclude that early and appropriate surgical treatment with complete examination is very important to prevent blepharoptosis, proptosis, limitation of eyeball movement and optic nerve compression. However, when globe rupture and blindness by direct injury of bony segment happened, the operation of enucleation was needed in this particular case.