UMEM Educational Pearls

Category: Trauma

Title: Facial trauma visual diagnosis

Keywords: facial trauma, orbit, fracture (PubMed Search)

Posted: 7/7/2024 by Robert Flint, MD (Updated: 7/17/2024)
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Question

Patient struck in left eye. The patient was asked to look up during exam and this is the finding. What imaging modality would you order if so inclined, what is the injury, and what is the disposition/plan? 

Answer

Concern for a left orbital “blowout” fracture with muscle entrapment. Also called the trapdoor fracture. CT is the imaging modality of  choice not plain films. This injury requires emergent consultation with a face surgeon (plastics, ENT or oculoplastics.).  Right orbital fracture in the photo below. 

References

1.https://www.researchgate.net/figure/Girl-with-blowout-fracture-of-the-left-orbit-and-enophthalmos_fig1_351847537

2.|The Lancet.  VOLUME 395, ISSUE 10221, P370, FEBRUARY 01, 2020

Football causes orbital trapdoor fracture with restricted eye movement

Paul Geraeds Kemps, BSc Michaël Herman Frank, MD

Published:  February 01, 2020DOI:https://doi.org/10.1016/S0140-6736(19)33223-4