Orbital Floor Fracture Management

ABSTRACT

Orbital floor fractures can occur in isolation or in conjunction with other facial skeletal fractures. They are commonly associated with midface fractures and, in this region, are second only to nasal fractures in occurrence. The integrity of the orbit and its contents must be preserved to prevent complications after alterations secondary to trauma. There is a plethora of literature on different reconstruction methods. Autogenous bone and cartilage grafts from various areas have been used in the reconstruction of the floor. In addition, materials such as high-density porous polyethylene, silicone, and titanium mesh have also been used. Each has its own benefits and limitations. The lack of stabilization and improper posterior placement of the reconstruction implant have caused less-than-ideal repairs. Graft stabilization can be accomplished with titanium screw fixation, and recently the endoscope has facilitated the visualization of the entire defect and helped ensure the proper placement of the implant.

KEYWORDS

Orbital floor fractures - endoscopic repair

REFERENCES

• 1 Rhee J S, Kilde J MD, Yoganadan N, Pintar F. Orbital blowout fractures: experimental evidence for the pure hydraulic theory.  Arch Facial Plast Surg. 2002;  4 98-101
• 2 Grant 3rd J H, Patrinely J R, Weiss A H, Kierney P C, Gruss L S. Trapdoor fracture of the orbit in a pediatric population.  Plast Reconstr Surg. 2003;  109 482-489
• 3 Bansagi Z C, Meyer D R. Internal orbital fractures in the pediatric age group: characterization and management.  Ophthalmology. 2000;  107 829-836
• 4 Egbert J E, May K, Kersten R C, Kulwin D R. Pediatric orbital floor fracture: direct extraocular muscle involvement.  Ophthalmology. 2000;  107 1875-1879
• 5 Ng P, Chu C, Young N, Soo M. Imaging of orbital floor fractures.  Australas Radiol. 1996;  40 264-268
• 6 Burnstine M A. Clinical recommendations for repair of orbital facial fractures.  Curr Opin Ophthalmol. 2003;  14 236-240
• 7 Strong E B, Kim K K, Diaz R C. Endoscopic approach to orbital blowout fracture repair.  Otolaryngol Head Neck Surg. 2004;  131 683-695