Classification of Manson et al for a Naso-OrbitoEthmoid (NOE) Fracture

Manson et al classified fractures involving the naso-orbitoethmoid (NOE) complex along the medioinferior aspect of the orbit.

Parameters:

(1) size and number of bone fragments

(2) status of the medial canthal tendon and its osseous insertion (in the region of the lacrimal fossa)

Number of Bone Fragments	Medial Canthal Tendon	Type
few and large	intact	I
multiple and small (comminution)	intact	II
variable	disrupted	III

Complications:

(1) telecanthus (increased separation of the inner canthi, especially with disruption of the medial canthal tendon)

(2) malpositioning of the globe

(3) damage to the walls of the ethmoid sinus

(4) disruption of the nasofrontal duct, with risk of mucocele (especially with comminution)

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