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  • Title: Mechanisms of orbital blowout fracture: a critical review of the literature.
    Author: Adeyemo WL, Aribaba OT, Ladehinde AL, Ogunlewe MO.
    Journal: Niger Postgrad Med J; 2008 Dec; 15(4):251-4. PubMed ID: 19169343.
    Abstract:
    OBJECTIVE: The aim of the present study is to critically review relevant literature regarding the mechanism of blowout fractures of the orbit and provide an answer to the question: Can one theory adequately explain the mechanism of orbital blowout fractures in the light of present day knowledge? MATERIALS AND METHODS: A computerised literature search using MEDLINE was conducted for published articles on orbital blowout fractures. Mesh phrases used in the search were: orbital blowout fractures AND mechanisms; orbital blowout fractures AND theory; orbital wall injury AND mechanisms. Only relevant articles were selected for the review. RESULTS: The physical mechanism of orbital blowout fracture has been a subject of debate for years by maxillofacial surgeons, ophthalmologists, plastic surgeons, otolaryngologists and orbitologists. However, only 3 mechanisms of injury have been proposed namely: "hydraulic" theory, "globe-to-wall" theory and "bone conduction" theory. Most of the theories of orbital blowout fractures have been confirmed through brilliant experiments and hypothetical explanation/analysis of clinical and radiologic findings, and each one appears to fit according to the different type of trauma received. CONCLUSIONS: Based on contemporary evidence, one theory may not adequately explain all types of fractures completely or be responsible exclusively in a given case for the pattern of fracture observed. Blowout fractures of the orbit could therefore be due to a combination of 2 or more mechanisms.
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