Related Experiment Video
Updated: Jul 19, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Orbital blow-out fractures: surgical timing and technique
1Section of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, USA. gjharris@mcw.edu
Purpose:
To recommend a tailored approach to surgical timing in the repair of orbital blow-out fractures, and to offer suggestions for improved functional and aesthetic surgical outcomes.
Methods:
Traditional guidelines for surgical timing are reviewed. An evidence-based approach that considers soft-tissue disruption relative to bone-fragment separation is presented. The author's techniques for repair of isolated orbital floor, isolated medial wall, and combined floor-medial wall fractures are presented.
Results:
As demonstrated previously, greater degrees of soft-tissue incarceration or displacement, with presumably greater intrinsic damage and subsequent fibrosis, result in poorer motility outcomes despite complete release of soft tissues. There is a suggestion that earlier intervention for such injuries might improve outcomes. Lower fornix and transcaruncular incisions, careful extrication of incarcerated tissue, and thin alloplastic implants have proven successful in the author's hands.
Conclusions:
The degree of soft-tissue displacement relative to bone fragment distraction, as depicted in preoperative computed tomography (CT) scans, should be considered in the timing of surgery. Incisions, soft-tissue handling, and implant material, thickness, and positioning can all affect the functional and aesthetic outcomes.
