Archives of Plastic Surgery

  • 제42권4호
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  • Pages.424-430
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  • 2015
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Combined Orbital Fractures: Surgical Strategy of Sequential Repair

  • Hur, Su Won (Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine) ;
  • Kim, Sung Eun (Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine) ;
  • Chung, Kyu Jin (Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine) ;
  • Lee, Jun Ho (Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine) ;
  • Kim, Tae Gon (Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine) ;
  • Kim, Yong-Ha (Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
  • 투고 : 2015.04.15
  • 심사 : 2015.06.01
  • 발행 : 2015.07.15
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초록

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.

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참고문헌

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  8. Cho RI, Davies BW. Combined orbital floor and medial wall fractures involving the inferomedial strut: repair technique and case series using preshaped porous polyethylene/titanium implants. Craniomaxillofac Trauma Reconstr 2013;6: 161-70. https://doi.org/10.1055/s-0033-1343785
  9. Scolozzi P, Momjian A, Heuberger J, et al. Accuracy and predictability in use of AO three-dimensionally preformed titanium mesh plates for posttraumatic orbital reconstruction: a pilot study. J Craniofac Surg 2009;20:1108-13. https://doi.org/10.1097/SCS.0b013e3181abb44b
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피인용 문헌

  1. Application of Rapid Prototyping Technique and Intraoperative Navigation System for the Repair and Reconstruction of Orbital Wall Fractures vol.17, pp.3, 2015, https://doi.org/10.7181/acfs.2016.17.3.146
  2. Feasibility of Single Folded Unsintered Hydroxyapatite Particles/Poly-L-Lactide Composite Sheet in Combined Orbital Floor and Medial Wall Fracture Reconstruction vol.26, pp.2, 2015, https://doi.org/10.2485/jhtb.26.237
  3. Reconstruction of Medial Orbital Wall Fractures without Subperiosteal Dissection: The "Push-Out" Technique vol.44, pp.6, 2015, https://doi.org/10.5999/aps.2017.01319
  4. Differences in Common Orbital Blowout Fracture Sites by Age : vol.141, pp.6, 2015, https://doi.org/10.1097/prs.0000000000004397
  5. Delayed reconstruction of posttraumatic facial deformities vol.61, pp.12, 2018, https://doi.org/10.5124/jkma.2018.61.12.740
  6. Patient-specific puzzle implant preformed with 3D-printed rapid prototype model for combined orbital floor and medial wall fracture vol.71, pp.4, 2018, https://doi.org/10.1016/j.bjps.2017.11.016
  7. Orbital trapdoor fractures: different clinical profiles between adult and paediatric patients vol.102, pp.7, 2015, https://doi.org/10.1136/bjophthalmol-2017-310890
  8. New Algorithm for the Management of Orbital Blowout Fracture Based on Prospective Study vol.11, pp.4, 2015, https://doi.org/10.1055/s-0038-1641714
  9. Big Data Statistical Analysis of Facial Fractures in Korea vol.35, pp.7, 2015, https://doi.org/10.3346/jkms.2020.35.e57
  10. Restoration of the inferomedial orbital strut using a standardized three‐dimensional printing implant vol.236, pp.5, 2020, https://doi.org/10.1111/joa.13136
  11. Comparison of Efficacy between Three-Dimensional Printing and Manual-Bending Implants for Inferomedial Orbital Fracture: A Retrospective Study vol.11, pp.17, 2015, https://doi.org/10.3390/app11177971
  12. Endoscopic repair of combined orbital floor and medial wall fractures involving the inferomedial strut vol.35, pp.10, 2021, https://doi.org/10.1038/s41433-020-01304-0