Bilateral Blow-in Fractures of the Orbital Roofs caused by the Ballistic Effect of a High-velocity Stone: An Unusual Presentation of Orbital Trauma

Abstract

We describe a unique case of bilateral blow-in fractures of the orbital roofs. A previously healthy 6-year-old boy was brought to the emergency department after a stone thrown by a car wheel hit his face while sitting on the sidewalk. Maxillofacial and orbital computed tomography revealed nasoethmoid and anterior skull base fractures involving the superior orbital roofs, which were displaced towards the orbit, diagnosed as bilateral orbital roof blow-in and bilateral medial wall blow-out fractures. The patient had rhinorrhea and massive nasal bleeding. An open reduction was performed by a neurosurgeon. This unusual case had an atypical etiology.