| A Case of Pediatric Medial-Orbital Wall Fracture with Extraocular Muscle Entrapment. |
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Seung Hwan Jo, Soo Jin Kim |
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Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea. pearlsj@hanmail.net |
| 외안근 감돈을 동반한 소아 안와내벽골절 1예 |
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조승환⋅김수진 |
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메리놀병원 안과 |
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Received: 27 September 2014 • Revised: 15 January 2015 • Accepted: 6 May 2015 |
| Abstract |
PURPOSE
To report a case of pediatric medial wall blowout fracture with entrapment of medial rectus muscle which can be easily misdiagnosed as a cerebral lesion. CASE SUMMARY: A 16-year-old male visited our clinic with headache, severe restriction of his right eye movement, and diplopia after a head injury due to falling occurring 1 day before evaluation. The patient was inebriated at the time of the accident and could not recall the event but occipital hematoma was palpable. Periorbital ecchymosis or edema was not observed with minimal soft tissue injury except mild conjunctival injection on slit-lamp examination. The patient had an 18 prism diopter exodeviation at primary position and severe medial and mild lateral gaze limitation in his right eye. Brain magnetic resonance imaging (MRI) showed no specific cerebral findings although trapdoor orbital medial wall fracture with incarceration of soft tissue and medial rectus muscle at the medial wall fracture site of his right eye was observed. Within 48 hours from the first evaluation, the blowout fracture was repaired and 50 days postoperatively, right eye gaze limitation and diplopia were nearly recovered. CONCLUSIONS: A case of pediatric blowout fracture with uncertain injury location, periocular ecchymosis, or edema absent could be misdiagnosed as a cerebral lesion. If a pediatric patient is experiencing gaze limitation, diplopia, nausea, or vomiting after trauma, neurological examination as well as evaluation for blowout fracture should be performed. |
| Key Words:
Entrapment of medial rectus muscle;Pediatric medial wall blowout fracture;White-eyed blowout fracture |
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