Timing of return to normal activities after orbital floor fracture repair

Orbital floor fractures are among the most common facial fractures, and patients and surgeons often ask when the patient can resume normal activities after surgical treatment. This study attempted to address this basic issue by examining wound strength and histologic characteristics after orbital floor fracture repair with three commonly used materials.

Twenty-one female goats were anesthetized under general anesthesia. A systematic approach was used to fracture both orbits (n = 42 orbits) and measure the energy required to create the fractures. The orbits were repaired with one of three different materials. One-third of the orbits were then refractured at 10, 24, or 45 days after the initial injury. The energy required to fracture the orbit was measured, and histopathologic samples were taken.

Preoperative fracture strength was largely regained after 10 days and before 24 days following the initial injury and repair, regardless of fracture repair material. LactoSorb and polyamide sheeting were associated with a lower incidence of postoperative seroma formation and thicker capsule formation than was Silastic sheeting. Wound strength in orbits repaired with Silastic sheeting during the initial postoperative period was inferior compared with orbits repaired with LactoSorb or polyamide sheeting. However, in the longer term, wound strength was not statistically different for any of the materials used in fracture repair.

Orbital floor strength is regained 24 days after repair. The authors now let patients resume normal activities approximately 3 weeks after uncomplicated orbital floor fracture repair. This is one of many clinical factors in assessing the return to normal activities. In addition, LactoSorb and polyamide sheeting are adequate for the repair of simple floor fractures.