Classification of orbital floor fractures

A retrospective series of orbital, axial, and coronal computed tomography scans from 24 orbital floor fractures was studied to define the anatomic location of the fracture. Floor fractures without rim involvement, which are referred to clinically as blowout fractures, were located medial to the infraorbital nerve or extended on both sides of the nerve. Floor fractures with rim involvement were associated with zygomatico-orbital or Le Fort II or III fractures, and were located either lateral to or on both sides of the infraorbital nerve. No blowout fractures were confined to the lateral half of the orbital floor and no floor fractures with rim involvement were confined to the medial half of the orbital floor. The authors propose a classification system for describing orbital floor fractures based on their anatomic location relative to the infraorbital nerve.