Image Based Question – 67319

The symptom as shown in the picture below is a common symptom of which among the following fractures ?

A. Blow out fracture.

B. Depressed fracture.

C. Linear fractures.

D. Ping-pong fracture.

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Correct Answer » A Explanation

Ans:A .Blow out fracture

Bruising around the eye as shown in the picture above is a common symptom of blow out fractures.

• Orbital blow-out fractures occur when there is a fracture of one of the walls of orbit but the orbital rim remains intact.

• Typically, this is caused by a direct blow to the central orbit from a fist or ball.

Epidemiology

• The blow-out fracture is the commonest type of orbital fracture and is usually the result of trauma, often of sporting origin. This is reflected in the demographics and the fact that the commonest group of patients are young men.

Clinical presentation

Orbital blow-out fractures are usually the result of a direct blow to the orbit. This results in a sudden increase in the intraorbital pressure which in turn causes decompression by fracture of one or more of the bounding walls of the orbit.

The trauma is usually substantial, but presentation and diagnosis may sometimes delayed. This delay is usually due to intact orbital rim (by definition) and swelling making assessment of diplopia and extra-ocular movement difficult.

Associated clinical findings may include:

• enophthalmos: due to increased orbital volume

• diplopia: due to extra-ocular muscle entrapment

• orbital emphysema: especially when fracture is into an adjacent paranasal sinus

• malar region numbness: due to injury to the inferior orbital nerve

• hypoglobus