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Combined Orbital Fractures: Surgical Strategy of Sequential Repair
BACKGROUND: Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. METHODS: We divided 74 patients who underwent the reconstruction of the...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Plastic and Reconstructive Surgeons
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513050/ https://www.ncbi.nlm.nih.gov/pubmed/26217562 http://dx.doi.org/10.5999/aps.2015.42.4.424 |
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author | Hur, Su Won Kim, Sung Eun Chung, Kyu Jin Lee, Jun Ho Kim, Tae Gon Kim, Yong-Ha |
author_facet | Hur, Su Won Kim, Sung Eun Chung, Kyu Jin Lee, Jun Ho Kim, Tae Gon Kim, Yong-Ha |
author_sort | Hur, Su Won |
collection | PubMed |
description | BACKGROUND: Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. METHODS: We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. RESULTS: In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. CONCLUSIONS: We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon. |
format | Online Article Text |
id | pubmed-4513050 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | The Korean Society of Plastic and Reconstructive Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-45130502015-07-27 Combined Orbital Fractures: Surgical Strategy of Sequential Repair Hur, Su Won Kim, Sung Eun Chung, Kyu Jin Lee, Jun Ho Kim, Tae Gon Kim, Yong-Ha Arch Plast Surg Original Article BACKGROUND: Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. METHODS: We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. RESULTS: In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. CONCLUSIONS: We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon. The Korean Society of Plastic and Reconstructive Surgeons 2015-07 2015-07-14 /pmc/articles/PMC4513050/ /pubmed/26217562 http://dx.doi.org/10.5999/aps.2015.42.4.424 Text en Copyright © 2015 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Hur, Su Won Kim, Sung Eun Chung, Kyu Jin Lee, Jun Ho Kim, Tae Gon Kim, Yong-Ha Combined Orbital Fractures: Surgical Strategy of Sequential Repair |
title | Combined Orbital Fractures: Surgical Strategy of Sequential Repair |
title_full | Combined Orbital Fractures: Surgical Strategy of Sequential Repair |
title_fullStr | Combined Orbital Fractures: Surgical Strategy of Sequential Repair |
title_full_unstemmed | Combined Orbital Fractures: Surgical Strategy of Sequential Repair |
title_short | Combined Orbital Fractures: Surgical Strategy of Sequential Repair |
title_sort | combined orbital fractures: surgical strategy of sequential repair |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513050/ https://www.ncbi.nlm.nih.gov/pubmed/26217562 http://dx.doi.org/10.5999/aps.2015.42.4.424 |
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