Influence of fractures in different inferior orbital wall locations on ocular motility disorders

Orbital floor fractures affect eye movement, but the underlying mechanism remains unclear. [...]the present retrospective study aimed to clinically characterize fractures in different inferior orbital wall locations, and to determine the relationship between fracture type and ocular motility disorder. The tilted end of the fracture plate is located in the maxillary sinus while the other is connected to the orbital wall, resulting in the lower rectus sheath or surrounding soft tissues being clamped on the fracture site. Because the inferior rectus muscle has abundant adipose tissue between this site and the orbital floor, it plays a certain protective role. The main feature here is that the fracture is located in the suborbital groove where the suborbital fissure meets the orbital apex; most cases were large-area collapsed fractures of the orbital floor between the inferior orbital fissure and the ethmoid maxillary suture, and the orbital contents were partly emptied into the maxillary sinus cavity. Because the oculomotor nerve branches into the lower rectus muscle site while the muscle itself may also show contusion, and ophthalmoplegia may occur, affecting eye performance. Lee et al[3] suggested that during the movement of the inferior rectus muscle from the orbital tip to the end of the sclera in the eyeball, there is less adipose tissue between the lower part of the inferior orbital wall and the orbital floor.