Orbital Floor Fracture

These images demonstrate downward buckling of the inferior orbital wall involving the medial aspect of the infraorbital canal compatible with fracture. There is associated downward herniation of fat as well as the inferior rectus muscle into the left maxillary sinus. Herniation of the inferior rectus may lead to entrapment which is a purely clinical diagnosis. This patient had evidence of entrapment on clinical exam and presented with restricted upward gaze. These type of fractures usually result from a direct blow to the orbit. Approximately 50% will be associated with medial orbital wall fracture. The infraorbital canal is a site of weakness.