[Diagnosis and therapy of median blow-out fractures]

Isolated medial blow-out fractures are rare. This report presents such a case in which blunt trauma to the orbit due to a ski accident was followed by herniation of the orbital fasciae and the nasal orbital tissue into the ethmoid and nasal cavity resulting in ptosis, enophthalmos, and total motility impairment in all directions. In particular, an incomplete abduction could be detected. To avoid recurrent infections, because of communication with the pneumatic cells of sinuses, a composite graft from the nasal septum was used for the reconstruction of the medial orbital wall.