Orbital floor fractures: clinical characteristics, mechanisms of injury, and surgical outcomes in a 25-year single-center study.

PURPOSE: Orbital floor fractures are common injuries following blunt midfacial trauma, presenting as isolated defects or as part of complex craniofacial fractures. This study aimed to evaluate clinical characteristics, fracture patterns, management strategies, and postoperative outcomes in surgically treated patients. METHODS: This retrospective single-center study included 56 patients who underwent surgical treatment for orbital floor fractures between 2000 and 2025. Demographic data, injury mechanisms, imaging findings, associated fractures, clinical presentation, surgical techniques, and outcomes were analyzed. Minimum follow-up was 3 months. Statistical analysis was performed using IBM SPSS Statistics version 25.0, with p < 0.05 considered significant. RESULTS: Among 56 patients, 80.4% were male, with a mean age of 38.6 years (10-70). Assault (44.6%) was the most common cause, followed by in-vehicle accidents (21.4%) and falls (17.9%). Inferior wall fractures were most frequent (55.4%), followed by medial (28.6%) and lateral (16.1%) involvement; no superior fractures were observed. Common findings included periorbital edema/ecchymosis (75.0%), diplopia (26.8%), and gaze limitation (19.6%); infraorbital hypoesthesia occurred in 12.5%. Associated fractures involved the maxilla (60.7%) and zygoma (46.4%).Surgical treatment included exploration/elevation (46.4%), titanium mesh (19.6%), and cartilage grafting (33.9%).Complications occurred in 19.6%, highest in the titanium mesh group, while none occurred with cartilage grafts. No independent predictors were identified. CONCLUSION: Orbital floor fractures mainly affect young males and are most often caused by assault. The inferior wall is most commonly involved, and outcomes vary by reconstruction method without independent predictors of complications.