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Orbital blowout fracture
An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall, typically resulting from impact of a blunt object larger than the orbital aperture, or eye socket. There are two broad categories of blowout fractures: ''open door'', which are large, displaced and comminuted, and ''trapdoor'', which are linear, hinged, and minimally displaced. They are characterized by double vision, sunken ocular globes, and loss of sensation of the cheek and upper gums due to infraorbital nerve injury.
In ''pure'' orbital blowout fractures, the orbital rim (the most anterior bony margin of the orbit) is preserved, while with ''impure'' fractures, the orbital rim is also injured. With the trapdoor variant, there is a high frequency of extra-ocular muscle entrapment, despite minimal signs of external trauma, a phenomenon referred to as a 'white-eyed' orbital blowout fracture. They can occur with other injuries such as transfacial Le Fort fractures or zygomaticomaxillary complex fractures. The most common causes are assault and motor vehicle accidents. In children, the trapdoor subtype are more common. Reconstruction is usually performed with a titanium mesh or porous polyethylene through a transconjunctival or subciliary incision. More recently, there has been success with endoscopic, or minimally invasive, approaches.
==History==
Orbital floor fractures were investigated and described by MacKenzie in Paris in 1844 and the term ''blow out fracture'' was coined in 1957 by Smith & Regan, who were investigating injuries to the orbit and resultant inferior rectus entrapment, by placing a hurling ball on cadaverous orbits and striking it with a mallet.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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