According to a retrospective review of 111 orbital fractures in the US:[5]Manolidis S, Weeks BH, Kirby M, et al. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg. 2002 Nov;13(6):726-37.
http://www.ncbi.nlm.nih.gov/pubmed/12457084?tool=bestpractice.com
Zygomatic complex fractures involving the orbit are the most common (50%), followed by the naso-ethmoid-orbital (NEO) region in 32% and the frontal region in 28% of cases.
Of the orbital walls, 4 walls are involved in 5%, 3 walls in 17%, 2 walls in 30%, and 1 wall in 50% of cases.
Associated ocular injury occurs in 33%, and neurological injury in 57% of patients.
Another retrospective review, also from the US, found orbital floor fractures (48%) and medial wall fractures (25%) are the most common, with left-sided fractures more common than right-sided fractures.[6]Chiang E, Saadat LV, Spitz JA, et al. Etiology of orbital fractures at a level I trauma center in a large metropolitan city. Taiwan J Ophthalmol. 2016 Feb 12;6(1):26-31.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602121
http://www.ncbi.nlm.nih.gov/pubmed/29018706?tool=bestpractice.com
In the US, the estimated annual incidence of orbital floor fractures is 8.9 per 100,000 people.[7]Ramirez DA, Porco TC, Lietman TM, et al. Ocular injury in United States emergency departments: seasonality and annual trends estimated from a nationally representative dataset. Am J Ophthalmol. 2018 Jul;191:149-55.
https://www.ajo.com/article/S0002-9394(18)30201-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29750945?tool=bestpractice.com
In the US and UK, the incidence of orbital fractures appears to be increasing.[8]Davies R, Hammond D, Ridout F, et al. British Association of Oral and Maxillofacial Surgeons' National Facial Injury Surveys: hard tissue facial injuries presenting to UK emergency departments. Br J Oral Maxillofac Surg. 2020 Feb;58(2):152-7.
http://www.ncbi.nlm.nih.gov/pubmed/31866062?tool=bestpractice.com
[9]Iftikhar M, Canner JK, Hall L, et al. Characteristics of orbital floor fractures in the United States from 2006 to 2017. Ophthalmology. 2021 Mar;128(3):463-70.
http://www.ncbi.nlm.nih.gov/pubmed/32659309?tool=bestpractice.com
The most common cause of orbital floor fractures is assault (43%), followed by falls (26%).[9]Iftikhar M, Canner JK, Hall L, et al. Characteristics of orbital floor fractures in the United States from 2006 to 2017. Ophthalmology. 2021 Mar;128(3):463-70.
http://www.ncbi.nlm.nih.gov/pubmed/32659309?tool=bestpractice.com
Approximately 70% of patients with orbital fractures are male, and most are aged 18-45 years.[6]Chiang E, Saadat LV, Spitz JA, et al. Etiology of orbital fractures at a level I trauma center in a large metropolitan city. Taiwan J Ophthalmol. 2016 Feb 12;6(1):26-31.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602121
http://www.ncbi.nlm.nih.gov/pubmed/29018706?tool=bestpractice.com
[10]Ko MJ, Morris CK, Kim JW, et al. Orbital fractures: national inpatient trends and complications. Ophthalmic Plast Reconstr Surg. 2013 Jul-Aug;29(4):298-303.
http://www.ncbi.nlm.nih.gov/pubmed/23778290?tool=bestpractice.com
Falls are the most common cause of orbital fractures in women and in patients age ≥50 years.[6]Chiang E, Saadat LV, Spitz JA, et al. Etiology of orbital fractures at a level I trauma center in a large metropolitan city. Taiwan J Ophthalmol. 2016 Feb 12;6(1):26-31.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602121
http://www.ncbi.nlm.nih.gov/pubmed/29018706?tool=bestpractice.com