Linear trapdoor or “white-eye” blowout fracture of the orbit: not restricted to children

Abstract The management of orbital blowout fractures remains controversial, particularly in patients with a white-eye or trapdoor-type injury. We report our experience with 10 such cases (mean age 19.6 years, range 4–53) and show, unlike previous reports, that this pattern of injury is not restricte...

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Bibliographic Details
Published in:British journal of oral & maxillofacial surgery 2011-03, Vol.49 (2), p.142-147
Main Authors: Ethunandan, M, Evans, B.T
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Blowout fracture
Child
Child, Preschool
Dentistry
Diplopia
Diplopia - etiology
Female
Fracture Fixation, Internal - methods
Humans
Injuries of the limb. Injuries of the spine
Male
Medical sciences
Middle Aged
Orbital Fractures - complications
Orbital Fractures - pathology
Orbital Fractures - surgery
Otorhinolaryngology. Stomatology
Retrospective Studies
Surgery
Trapdoor defect
Traumas. Diseases due to physical agents
Treatment Outcome
White eye
Young Adult
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Summary:Abstract The management of orbital blowout fractures remains controversial, particularly in patients with a white-eye or trapdoor-type injury. We report our experience with 10 such cases (mean age 19.6 years, range 4–53) and show, unlike previous reports, that this pattern of injury is not restricted to children. Although most patients had a white eye (70%), the presence of subconjunctival haemorrhage and periorbital bruising did not exclude this injury, and the patients often (60%) had serious autonomic symptoms such as nausea and vomiting. A high index of suspicion and cross-sectional imaging is required to confirm the diagnosis. Early intervention (less than 7 days) seems to be associated with better outcome, but patients benefitted from intervention up to 41 days after injury. The mechanism underlying this pattern of injury and the rationale behind early intervention is also discussed.
ISSN:0266-4356
1532-1940
DOI:10.1016/j.bjoms.2010.03.012