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This patient is a 26 year old male who presents to the ED with the complaint of left eye pain after being assaulted. The following ray is shown.
Questions:
1. Describe what you see? Facial Bones AP which shows a left displace medial Orbital wall fracture.
Diagnosis: Medial Orbital Wall Fracture
2. How do these patients present?
Patients may present with periorbital edema and ecchymosis, (nasal) subconjunctival hemorrhage (all nonspecific), subcutaneous emphysema, epistaxis, CSF rhinorrhea, narrowing of the palpebral fissure with forced lateral duction, restriction of abduction, limitation of adduction, the acquired retraction syndrome or retraction of the globe on attempted abduction or adduction, horizontal diplopia, and progressive enophthalmos. Medial wall fractures also tend to be commonly associated with nasal fractures. The most striking features of an isolated medial wall fracture are diplopia on medial and lateral gaze and/or enophthalmos
3. What are the complications?
Medial Orbital wall fractures rarely develop complications. Some patients may experience restricted and painful abduction, pseudo-sixth-nerve paresis and pseudo-Duane's-retraction syndrome.
4.What would be your management for this patient?
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