Think twice before referring your orbital blowout fracture patients. According to a recent study, treating these cases conservatively might still yield positive results. Researchers evaluated the initial and follow-up computed tomography (CT) scans of conservatively treated orbital blowout fracture patients for smoothening of bony contour, joining of bony edges, reduction in herniation of orbital contents and new bone formation. 

Of the 44 orbits in the study, all showed bony contour changes from the initial CT scan to the follow-up, with 88.6% showing smoothening of the orbital contour, 90.9% showing joining of bony edges and 65.9% showing reduction in herniation of orbital contents. Additionally, 93.2% of orbits displayed features of neobone formation, 91.4% displayed a significant decrease in orbital volume and 94.3% displayed a significant decrease in fracture volume.

“A large proportion of patients showed improvement in radiologic findings despite being treated conservatively,” the study concluded. “This highlights the spontaneous improvement that can occur in untreated blowout fractures not just clinically, but radiologically, in terms of soft tissue and bony findings.”

Young SM, Kim YD, Kim SW, et al. Conservatively treated orbital blowout fractures. Ophthalmology. 2018;125(6):938-44.