The indications for surgical repair of the orbital blowout fracture are controversial. One reason may be case variation among fracture types. We therefore focused on linear-type blowout fractures in this study. The study included 22 consecutive cases of linear-type floor fractures. Demographics, clinical and CT findings, surgical timing, postoperative course, and outcome were evaluated. Surgery was performed in 14 cases for diplopia but not enophthalmos. Five cases with severe vertical diplopia were defined as "missing rectus" by CT findings. Residual diplopia remained in two cases with "missing rectus", while the other 20 cases completely recovered eye motility. In the 9 cases without muscle entrapment, diplopia disappeared within four weeks after operation. However recovery in cases with "missing rectus" took more than one month. Thus the CT finding with or without muscle involvement was crucial for linear-type blowout fractures. A comprehensive and timely decision based on clinical and radiological findings is indispensable for satisfactory management as well Linear-type Orbital Floor Fracture. 3 as postoperative rehabilitation.

If computed tomographic findings disclose a linear fracture with muscular strangulation, urgent surgery must be performed. However, for linear fractures without impaction of the muscle, or punched-out or burst type fractures, close observation for days may be appropriate. In addition, surgical intervention can be performed electively when diplopia persists for several days of observation.

No abstract