Reconstruction of orbital floor fractures with Polypropylen mesh

Various materials for reconstruction of bone defects in orbital floor fractures have been developed and clinically applied. The aim of this study is to evaluate the contribution of using the Polypropylene mesh as a reconstructive material for orbital floor mean-size defects.

We retrospectively reviewed the clinical charts of 40 patients who underwent post traumatic orbital floor reconstructive surgery. The selection criterias were : unilateral Blow-out orbital floor fracture with a defect size less then 2 cm² and the presence of diplopia, orbital tissue incarceration or enophtalmous ≥ 2mm.

A male predominance was observed (82.5%) with a mean age of 31.3 years. The main injury etiology was vehicle accidents (62.5%). Preoperatively, diplopia (62.5%) and enophtalmous (50%) were predominant. The diagnosis of fracture was confirmed by the computed tomography. The orbital floor was explored via a transconjunctival approach in the majority of cases (92.5%). The reconstruction was made with polypropylene mesh. No infection or exposure of the material had happened. Postoperatively, diplopia remained in 36% of cases, enophtalmos in 15% of cases and infraorbital nerve hypoesthesia in 33.3% of cases.

In this study, we found that since the availibility, the non resorbable character, the easy manipulation and the stability of the postoperative results which are similar to those of other studies, the Polypropylene mesh could be introduced in the reconstruction of the mean-size orbital floor fractures.