Comprehensive management of orbital fractures

Orbital fractures are some of the more challenging injuries faced by the plastic surgeon. As such a prominent facial feature, even the most minor asymmetries following trauma can be distressing to the patient. In treating these patients, there are certain crucial aspects of both diagnosis and management that are critical to obtaining an optimal result. These include a careful preparative eye examination focusing on extraocular motility and any evidence of optic nerve compression. Candidates for surgery must be carefully selected based on firm indications such as a large orbital floor defect (>1 cm2), early enophthalmos, significant hypoglobus, or persistent diplopia in the primary field of gaze. Reconstruction should focus on anatomical restitution of the floor, taking great care to place the implant along the correct superior inclination of the orbit.