Linear-Type Orbital Floor Fracture With or Without Muscle Involvement

The indications for surgical repair of the orbital blowout fracture are controversial. One reason may be case variation among fracture types. We therefore focused on linear-type blowout fractures in this study. The study included 22 consecutive patients with linear-type floor fractures. Demographics, clinical and computed tomographic (CT) findings, surgical timing, postoperative course, and outcome were evaluated. Surgery was performed in 14 patients with diplopia but not enophthalmos. Five patients with severe vertical diplopia were defined as "missing rectus" by CT findings. Residual diplopia remained in 2 patients with "missing rectus," whereas the other 20 patients completely recovered eye motility. In the 9 patients without muscle entrapment, diplopia disappeared within 4 weeks after operation. However, recovery in patients with "missing rectus" took more than 1 month. Thus, the CT finding with or without muscle involvement was crucial for the linear-type blowout fractures. A comprehensive and timely decision based on clinical and radiologic findings is indispensable for satisfactory management as well as postoperative rehabilitation.