Orbital floor fracture
| Classification according to ICD-10 | |
|---|---|
| S02.3 | Fracture of the orbital floor |
| H50.6 | Mechanically induced strabismus - strabismus due to traumatic cause |
| ICD-10 online (WHO version 2019) | |
The orbital floor fracture (synonyms: blow-out fracture and positive pressure fracture ) is the (breakthrough) fracture of the floor of the orbit towards the maxillary sinus , usually caused by blunt contusion (e.g. after a punch or tennis ball injury) and usually associated with perception from double vision and significant disorders of eye movement . In particular, passive mobility is restricted here, as muscle , connective and holding tissue are often trapped in the fracture gap that has arisen, or muscle hematomas are responsible for the movement disorders . Further symptoms can be an increase in intraocular pressure when looking in the direction of the restricted movement, as well as sensory disturbances in the area of the cheeks and upper lip, enophthalmos and monocular hematomas .
In terms of differential diagnosis, mechanical limitations must be distinguished from neurogenic limitations. The so-called traction test (also: tweezer pull test ), a method to test the passive mobility of the eye, is used to differentiate between actual eye muscle paralysis and mechanically caused movement restrictions ( pseudoparesis ) .
treatment
In pure hyperbaric fractures, surgical treatment with reconstructions of the eye socket is controversial because the benefit and success are controversial. Often, spontaneous improvements are observed, which can occur especially in the first four weeks after the accident. For this reason, treatment and possible surgical intervention should be discussed in detail with all doctors involved ( ear , nose and throat doctor , oral surgeon , ophthalmologist , radiologist ) beforehand.
See also
Web links
literature
- Herbert Kaufmann (Ed.): Strabismus. With the collaboration of Wilfried de Decker et al. Enke, Stuttgart 1986, ISBN 3-432-95391-7 .
