A blow out fracture of the skull or orbital floor fracture is a fracture of the bones surrounding the eye. This kind of fracture usually occurs from a blow to the skull. This kind of fracture is commonly seen in automobile accidents.
Symptoms are usually swelling, bruising of the eye, nose bleeds, double vision and numbness of the checks.
Most blowout fractures heal on it's own and don't require surgery. Cold compresses to reduce swelling and time to heal the bone is all that is needed. If pain is present and severe when the eye is moved or numbness in cheeks doesn't go away then reconstructive surgery may be needed, and is usually performed within 2 weeks of the fracture.
Most blowout fractures heal without any long-term effects but sometimes the muscle of the eye is impaired and this condition is called strabismus, and causes double vision. When this occurs then surgery may be necessary to the muscles of the eye if the condition can't be corrected with glasses.
A trapdoor fracture is a relatively small orbital floor fracture with clinically significant muscle entrapment and is common in the pediatric population. Unlike a blow-out fracture though, prompt surgical intervention is necessary to avoid early tissue necrosis resulting from compromised vascular supply. Look for the same findings of a blow-out fracture, plus no supraduction, nausea, vomiting and the patient will usually exhibit intense pain. Like a blow-out fracture, a CT scan with coronal views is also indicated.
Image and caption is from: http://www.pacificu.edu/optometry/ce/courses/21042/primarycaretraumapg2.cfm
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