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The two broad categories of blowout fractures are open door and trapdoor fractures. ''Open door fractures'' are large, displaced and comminuted, and ''trapdoor fractures'' are linear, hinged, and minimally displaced.<ref name="Radiological findings of orbital bl">{{cite journal | vauthors = Valencia MR, Miyazaki H, Ito M, Nishimura K, Kakizaki H, Takahashi Y | title = Radiological findings of orbital blowout fractures: a review | journal = Orbit | volume = 40 | issue = 2 | pages = 98–109 | date = April 2021 | pmid = 32212885 | doi = 10.1080/01676830.2020.1744670 | s2cid = 214681849 }}</ref> The hinged orbital blowout fracture is a fracture with an edge of the fractured bone attached on either side.<ref>{{cite journal | vauthors = Young SM, Kim YD, Kim SW, Jo HB, Lang SS, Cho K, Woo KI | title = Conservatively Treated Orbital Blowout Fractures: Spontaneous Radiologic Improvement | journal = Ophthalmology | volume = 125 | issue = 6 | pages = 938–944 | date = June 2018 | pmid = 29398084 | doi = 10.1016/j.ophtha.2017.12.015 | s2cid = 4700726 | doi-access = free }}</ref>
In ''pure'' orbital blowout fractures, the orbital rim (the most anterior bony margin of the orbit) is preserved, but with ''impure'' fractures, the orbital rim is also injured. With the trapdoor variant, there is a high frequency of extra-ocular muscle entrapment despite minimal signs of external trauma, a phenomenon that is referred to as a "white-eyed" orbital blowout fracture.<ref name="Orbital fractures: role of imaging"/> The fractures can occur of pure floor, pure medial wall or combined floor and medial wall.They can occur with other injuries such as transfacial [[Le Fort fracture of skull|Le Fort fractures]] or [[zygomaticomaxillary complex fracture]]s. The most common causes are assault and motor vehicle accidents. In children, the trapdoor subtype are more common.<ref>{{cite journal | vauthors = Ellis E | title = Orbital trauma | journal = Oral and Maxillofacial Surgery Clinics of North America | volume = 24 | issue = 4 | pages = 629–648 | date = November 2012 | pmid = 22981078 | doi = 10.1016/j.coms.2012.07.006 }}</ref> Smaller fractures are associated with a higher risk of entrapment of the nerve and therefore often smaller fracture are more serious injuries. Large orbital floor fractures have less chance of restrictive [[strabismus]] due to nerve entrapment but a greater chance of enopthalmus.
There are a lot of controversies in the management of orbital fractures. the controversies debate on the topics of timing of surgery, indications for surgery, and surgical approach used.<ref name="Radiological findings of orbital bl"/> Surgical intervention may be required to prevent [[diplopia]] and [[enophthalmos]]. Patients not experiencing enophthalmos or diplopia and having good extraocular mobility may be closely followed by [[ophthalmology]] without surgery.<ref name=":2">{{Cite book|title=Otolaryngology head and neck surgery| vauthors = Flint PW, Cummings CW |date=2010-01-01|publisher=Mosby|isbn=9780323052832|oclc=664324957}}</ref>
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