Orbital Roof Fracture Management

A ct may already be appropriate due to a mechanism of injury or red flags for a head injury.

Orbital roof fracture management.

In cases of minor isolated orbital roof fractures where no surgical intervention is needed the patient. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof. Even in the context of floor fractures dr. After a thorough ophthalmic exam and after other trauma has been ruled out the patient and physician.

Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. Another potential emergency involves the roof not the floor of the orbit. Management of orbital roof fractures varies based on individual clinical features including the presence of exophthalmos gaze restriction and concomitant injuries such as dural tears. Investigation of orbital fractures is by x ray and ct with ct being the modality of choice though it can be unreliable in children with blowout fractures.

Surgically bicoronal approaches were performed most commonly along with reconstruction utilizing titanium miniplates. That s because they go headfirst over handlebars and tend to do a forehead plant. Most can be safely observed. The approach used is determined by the surgical needs of the patient.

Nondisplaced or minimally displaced orbital roof fractures are usually managed by observation but displaced orbital roof fractures can cause ophthalmic and neurologic complications and open surgical intervention is occasionally required. Approaches include extracranial intracranial and endonasal endoscopic.