A blowout fracture (frequently called a broken orbital bone) is a fracture of the floor or walls of the orbit, which consists of the bones surrounding the eye. When staring directly at the human skull, the orbit is the hole which encompasses the eye. A blowout fracture is typically caused by a blunt trauma blow to the head. There can be serious consequences, especially if there is significant damage to the medial orbital wall and orbital floor. The bones on the bottom of the orbit are the floor, the sides are the walls, and the bones on the top are called the roof. The most common symptoms are swelling and tenderness around the eye, tenderness, swelling, bruising, numbness of the teeth, nose, or cheek, nose bleeds, double vision, and redness of the eye. Symptoms that indicate a more serious injury may include air under the skin around the eye and severe pain when moving the eyes.
The most common cause of an orbital fracture is a direct blow to the facial area. When an object, such as a fist, ball, or stick, strikes the orbital bones (typically the upper cheek bone or eye brow), it transmits a large force to the bones. A large force can cause the bones to buckle and break. Any large object with speed or force can cause a blowout fracture. They frequently occur in mixed martial arts and boxing because as a result of taking a punch or kick to the face. They can also occur during hockey or any other sports where your face can be hit. For non-athletes, a blowout fracture tends to occur during a car accident. Blowout fractures are classified several different ways, by size and location, specific symptoms, and whether the bone is displaced or in place.
Treatment for a blowout fracture depends on the location and severity of the injury. For an uncomplicated, small blowout fracture that does not impact the movement of your eye, your doctor may recommend antibiotics, decongestants, and ice packs to decrease swelling. Make sure to wrap the ice pack in a thin towel to avoid causing skin damage. If you have a severe fracture however, your doctor will refer you to a reconstructive and plastic surgeon who specializes in eye injury treatment. The specialist will then determine if you require surgery to repair the broken bone or not. Surgery may be necessary if you have double vision, to remove bone fragments, to repair deformities, and to restore the normal architecture of the eye socket. Athletes may have surgery to help them return to play faster, while non-athletes may choose to avoid it if possible.
Most blowout fractures heal over time with no lasting long-term effects or complications. Follow-up examinations should assess and document muscle function. The recovery time depends on the severity of the injury. A mild fracture may heal within a month. A more severe fracture that requires surgery may take between 2-4 months to completely heal. The American Association for Pediatric Ophthalmology and Strabismus has more information on broken orbital bones and rehabilitation options. Luckily, most eye injuries can be prevented. If you play a sport where your eyes or face are susceptible to injury, make sure you wear proper equipment. This means a full cage or visor in hockey and goggles in basketball. For non-athletes, use appropriate protective eyewear in the work environment. Recent studies have proven that goggles and face shields reduce the risk of eye injuries in the work environment by over 90%. Lastly, make sure to always wear a seat belt when you ride in a car, as this can help you significantly during a car accident.