# Pure Orbital Floor Blow-In Fracture: An Extremely Rare Case

## TL;DR

A rare case of a pure orbital floor blow-in fracture in a 57-year-old man was successfully treated with surgery.

## Contribution

This paper presents a rare case of pure orbital floor blow-in fracture and its successful surgical treatment.

## Key findings

- The patient was diagnosed with a pure orbital floor blow-in fracture based on CT and Hess chart findings.
- Surgical removal of the bone fragment led to resolution of symptoms and a good outcome six months post-surgery.
- Only a few similar cases have been reported, highlighting the rarity of this condition.

## Abstract

A 57-year-old man presented with left diplopia on an upward gaze and ophthalmalgia after hitting the left side of his head. CT revealed a fracture on the left side of the orbital floor without orbital rim fractures and the protrusion of a small bone fragment into the orbit. Hess charts indicated markedly limited vertical movement of the left eye. Based on these findings, the patient was diagnosed with a pure orbital floor blow-in fracture (BIF). Symptoms persisted after a two-week monitoring period; therefore, the bone fragment was removed by a transcutaneous surgical approach with the assistance of a navigation system and an endoscope. Symptoms resolved after surgery, and CT and Hess examinations six months after surgery showed a good outcome. A pure BIF is rare, particularly on the orbital floor. Only a few similar case reports have been published to date, and we herein describe the surgical procedures performed and the treatment outcome of our case.