The missing muscle syndrome in blowout fractures: an indication for urgent surgery

Ophthalmic Plast Reconstr Surg. 1998 Jan;14(1):17-8. doi: 10.1097/00002341-199801000-00005.


The purpose to this study was to determine whether early surgical repair is indicated for a severely entrapped inferior rectus muscle following orbital blowout fracture. We report two patients with small blowout fractures, severe entrapment of the inferior rectus muscle, and an absence of the inferior rectus muscle in multiple contiguous coronal computed tomography cuts. At surgery, we released the severely entrapped inferior rectus muscles with resolution of diplopia. We concluded that patients with the "missing muscle syndrome" require urgent surgical intervention and that clinician review of radiologic studies is always prudent.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Diplopia / diagnostic imaging
  • Diplopia / etiology
  • Diplopia / surgery
  • Eye Injuries / etiology
  • Eye Injuries / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Oculomotor Muscles / diagnostic imaging
  • Oculomotor Muscles / injuries*
  • Oculomotor Muscles / surgery
  • Orbit / diagnostic imaging
  • Orbit / injuries*
  • Orbit / surgery
  • Orbital Fractures / diagnostic imaging
  • Orbital Fractures / etiology
  • Orbital Fractures / surgery*
  • Reconstructive Surgical Procedures
  • Recurrence
  • Syndrome
  • Tomography, X-Ray Computed