Blow out fracture of orbit most commonly leads to fracture of:
**Core Concept**
A blow out fracture of the orbit refers to a type of fracture that occurs when there is a break in one or more of the bones that make up the orbital floor or medial wall. This type of fracture is often caused by a direct blow to the globe, which results in increased intraorbital pressure and subsequent failure of the orbital floor or medial wall.
**Why the Correct Answer is Right**
The orbital floor is the most common site for a blow out fracture due to its thinness and the relatively high pressure of the maxillary sinus beneath it. When a direct blow to the globe occurs, the increased intraorbital pressure can cause the orbital floor to fracture, leading to herniation of orbital contents into the maxillary sinus. The orbital floor is more susceptible to fracture than the medial wall due to its thinner bone structure.
**Why Each Wrong Option is Incorrect**
**Option A:** This is incorrect because the zygomatic bone is more likely to fracture in a zygomatic complex fracture, which is a different type of orbital fracture.
**Option B:** This is incorrect because the lacrimal bone is part of the medial wall of the orbit, but it is not the most common site for a blow out fracture.
**Option C:** This is incorrect because the frontal bone is part of the roof of the orbit, and frontal bone fractures are typically associated with different types of trauma.
**Clinical Pearl / High-Yield Fact**
When evaluating a patient with a suspected blow out fracture, it is essential to perform a thorough examination of the orbit and surrounding structures, including the globe, extraocular muscles, and the bony orbit. A high index of suspicion for a blow out fracture should be maintained in patients with a history of direct trauma to the globe, particularly if they present with symptoms of diplopia, ptosis, or enophthalmos.
**Correct Answer:** The orbital floor.