Facts and fallacies of orbital floor injuries

Some established facts of the incidence, morbidity and significance of fractures of the orbital floor are presented. From a consideration of 819 explored orbits, some misconceptions and fallacies concerning the nature and management of these injuries are discussed. The traditional description and aetiology of "Blowout" fractures are examined and the relative frequency of damage to fat and muscle discussed. The value and safety of some diagnostic techniques are questioned--in particular the "forced duction" test. Misconceptions about the choice and management of implant materials are described. The fear of unacceptable facial scars or damaged optical function deters some operators from active treatment. It is suggested that undesirable sequelae are more likely after traditional blind elevation of facial fractures, or when surgery has been avoided, than after careful exploration and repair.