Orbital floor burst

Introduction After the eye is subjected to blunt violence, the internal pressure of the iliac crest suddenly rises, causing the fracture of the sacral floor (the maxillary sinus wall) to move down, which is called the bottom of the sac. Only the bottom fracture of the iliac crest is called a simple sacral floor rupture; if there is a lower iliac margin or other facial bone fracture, it is called a complex sacral burst. The sacral fracture piece and the tibial touch, fat, inferior rectus muscle, and inferior oblique muscle are trapped in the maxillary sinus, and there are eyeball collapse, upper and lower movement disorders, and diplopia. If accompanied by eyeball and optic nerve damage, vision loss or blindness. A sinus burst is a clinical manifestation of sinus trauma.

Cause

The front part of the eye is hit by a blunt object, and the tissue inside the sac is squeezed toward the tip of the sacrum. The intraocular pressure rises sharply, and the pressure is transmitted to the sacral wall. The fracture of the sacral wall is weak, and the soft tissue inside the iliac crest, such as the fat around the iliac crest, and the inferior rectus muscle. And the inferior oblique muscle is in the maxillary sinus and is incarcerated.

an examination

Related inspection

Ophthalmic examination ophthalmoscopy

X-ray films have important diagnostic value. The following lesions can be found in the nasal sputum position, nasal position and lateral position:

1 There is abnormal soft tissue shadow on the top of the maxillary sinus.

2 It can be seen that the tissue in the iliac crest is dislocated into the top of the maxillary sinus and is suspended by a hammock.

3 Sometimes blood and sacral bone fragments protrude into the maxillary sinus.

4 bottom bone defect.

The CT scan of the ankle and the CT scan of the coronal plane can clearly show the fracture state and the extent of the sputum content, and can also display other facial fractures, which can comprehensively evaluate the patient's injury.

Differential diagnosis

Differential diagnosis of the bottom of the sputum:

Polymorphic fracture of the eyelid

A linear fracture involves the maxilla and tibia.

2 comminuted fracture of the fundus, accompanied by a midface fracture.

3 fracture of the tibia, the frontal sulcus was separated, and the sacral floor was displaced downward.

2. Eyelid smashing fracture: The smashing fracture is also called the bottom of the blast. As early as 1889, Lang first reported a case of eyeball depression and diplopia caused by a fundus fracture. Later (King 1944) reported that Smith (1957) officially named the blow-out fracture.

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