Blow-out fractures of the orbit--imaging modalities and therapeutic results

Thirty-four cases of blow-out fracture were evaluated by high-resolution CT, Hess test for red and green color and synoptophore. The results of these tests were compared with the final outcome of the fractures. The fractures were classified on the basis of the location (floor, medial wall or roof), extent (total, partial or linear) and type of fragments (punched-out or trapdoor). The medial wall type included many cases (33%) with no complaint of double vision, and many cases with a combination of disturbances in ocular mobility in both the horizontal and vertical directions. The floor type showed a low incidence of disturbances in ocular movement in the horizontal directions. Regarding the extent of the fracture, all cases with the total type showed disappearance of double vision within three months. Many of the partial and linear types had a poor outcome. With regard to the type of fragments, all of the trapdoor type cases showed a favorable result with disappearance of double vision within three months. Some of the punched-out type cases, however, showed a poor outcome.