Question:medium
Which wall is most often fractured in a blow out fracture of the orbit due to a fisticuff injury?
Which wall is most often fractured in a blow out fracture of the orbit due to a fisticuff injury?
Show Hint
Think of the thinnest bone in the orbit, which lies over the maxillary sinus below the eye.
Updated On: Jul 8, 2026
- Superior wall
- Inferior wall
- Medial wall
- Lateral wall
Show Solution
The Correct Option is B
Solution and Explanation
Step 1: Picture the mechanism of injury.
A fist striking the eye pushes the eyeball backward, and this squeezes the soft tissue inside the bony orbit like a piston, spiking the pressure inside the cone shaped bone cavity.
Step 2: Ask where a piston like force escapes.
A raised pressure inside a closed box always breaks through the weakest wall first. In the orbit, the floor sits directly above the maxillary sinus and is built from paper thin bone, so it gives way before the thick rim or the strong lateral and superior walls.
Step 3: Confirm with the injuries seen afterward.
Surgeons see fat and eye muscle slipping down into the maxillary sinus through a broken floor, which produces a sunken looking eye and trouble looking up, plus numb cheek skin from the infraorbital nerve that runs along the floor. These findings would not happen if the fracture were in the roof or side wall.
Step 4: Compare with the medial wall.
The medial wall is thin too and can break, often alongside the floor, but taken alone the floor remains the single most frequent site.
Step 5: Conclude.
\[ \boxed{\text{Inferior wall}} \]
A fist striking the eye pushes the eyeball backward, and this squeezes the soft tissue inside the bony orbit like a piston, spiking the pressure inside the cone shaped bone cavity.
Step 2: Ask where a piston like force escapes.
A raised pressure inside a closed box always breaks through the weakest wall first. In the orbit, the floor sits directly above the maxillary sinus and is built from paper thin bone, so it gives way before the thick rim or the strong lateral and superior walls.
Step 3: Confirm with the injuries seen afterward.
Surgeons see fat and eye muscle slipping down into the maxillary sinus through a broken floor, which produces a sunken looking eye and trouble looking up, plus numb cheek skin from the infraorbital nerve that runs along the floor. These findings would not happen if the fracture were in the roof or side wall.
Step 4: Compare with the medial wall.
The medial wall is thin too and can break, often alongside the floor, but taken alone the floor remains the single most frequent site.
Step 5: Conclude.
\[ \boxed{\text{Inferior wall}} \]
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