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No substantial enophthalmos was ascertained in any of the six patients with balloon ruptures at their six-month follow-up visit. In cases featuring marginal screw fixation, blunt screws, and added protection by a resorbable foam dressing, a 1364% (6 out of 44) balloon rupture rate was documented. The orbital wall, fractured in a complex pattern, was repaired with balloon support and primary orbital fragments. The balloon rupture rate was 1364% (6