[1] The proximity of maxillary and ethmoidal sinus increases the susceptibility of the floor and medial wall for the orbital blowout fracture in these anatomical sites.

[2] The comparatively thin bone of the floor of the orbit and roof of the maxillary sinus has no support and so the inferior wall collapses mostly.

They are characterized by double vision, sunken ocular globes, and loss of sensation of the cheek and upper gums from infraorbital nerve injury.

With the trapdoor variant, there is a high frequency of extra-ocular muscle entrapment despite minimal signs of external trauma, a phenomenon that is referred to as a "white-eyed" orbital blowout fracture.

Patients not experiencing enophthalmos or diplopia and having good extraocular mobility may be closely followed by ophthalmology without surgery.

This may be attributed to the honeycomb structure of the numerous bony septa of the ethmoid sinuses, which support the lamina papyracea, thus allowing it to withstand the sudden rise in intraorbital hydraulic pressure better than the orbital floor.

[10] In children, the flexibility of the actively developing floor of the orbit fractures in a linear pattern that snaps backward.

[7] The trapdoor can entrap soft-tissue contents, thus causing permanent structural change that requires surgical intervention.

[citation needed] The bony orbital anatomy is composed of 7 bones: the maxillary, zygomatic, frontal, lacrimal, sphenoid, palatine, and ethmoidal.

Five cranial nerves (optic, oculomotor, trochlear, trigeminal, and abducens), and several vascular bundles, pass through the orbital socket.

[14] Thin cut (2-3mm) CT scan with axial and coronal view is the optimal study of choice for orbital fractures.

This polypoid mass consists of herniated orbital contents, periorbital fat and inferior rectus muscle.

[21] Surgical repair of a "blowout" is rarely undertaken immediately; it can be safely postponed for up to two weeks, if necessary, to let the swelling subside.

[25] The final incision option is infraorbital which allows the easiest access to the orbit but results in the most visible scar.

[27] The external group had ectropions, significant facial scars, extrusion of inserted Medpor, and intra-orbital hematoma.Disadvantage is working towards the globe rather than away with instruments.

[30] It has also been shown in the literature that put orbital medial wall fractures are more common in African Americans due to the increased density of their bone minerals compared to other ethnicities.

In the 1970s Putterman advocated for repair of virtually no orbital floor fractures and instead promoted watchful waiting for up to six weeks.