Blow-Out Fracture due to a Hazel Stick Beat

The aim of this case report is to demonstrate that blow-out fractures can occur not only by a classical trauma mechanism but also from the consequences of a stick beat. A 66-year-old male was admitted to our hospital complaining of a sudden swelling of his right eyelid after blowing his nose. In his medical history there was the report of a hazel stick beat the previous day. Upon ophthalmological examination, ecchymosis was observed in the right orbital region, and subcutaneous amphisema in addition to a dense subconjunctival hemorrhage were detected. Using computed tomography (CT), the intraorbital air density in the soft tissues and the right maxillary sinus wall fracture possessing fluid density compatible with hemorrhage was observed. The patient was treated conservatively with prednisolone and antibiotics. We conclude that a blow-out fracture may occur in patients who experience orbital trauma, even in cases of low-energy trauma. These patients may be symptomatic after an episode of hard nose-blowing.