Bony realignment in surgically treated orbital blowout fractures based on computed tomography

This study investigated postoperative bony realignment using follow-up computed tomography (CT) scans of patients with blowout fracture repair using an alloplastic implant.

This is a retrospective study of patients who underwent surgical treatment for orbital blowout fractures and had follow-up CT at least 4 months after the surgery. Preoperative, early, and late postoperative CT scans were obtained to assess the outcome measures including reduction completeness, reconstructed wall composition, and presence of implant-related complications. CT scans of patients with complications were compared with those of patients without complications for radiologic changes.

Our study comprised 48 orbits from 48 patients. The mean age was 28.1 years, the mean time from injury to surgery was 18.3 days, and the mean time from surgery to the latest CT scan was 47.2 months (4-212 months). Most orbits (n = 41, 91.7%) showed complete reduction postoperatively. Among the 36 patients without complications, 89% showed total and 11% showed partial bony coverage. Among the 12 patients with complications, 42% showed total, 42% showed partial, and 16% showed no bony coverage. Partial or no bony coverage was noted in 11.1% (4/36) of patients without complications and in 58.3% (7/12) with complications. Reconstructed wall composition was significantly related to the presence of complications (p = 0.002). The group with total bony coverage was younger than the group with partial or no bony coverage (p = 0.048).

A displaced bone in the sinus is repositioned in the early postoperative stage along with the implant substantially. Partial or no bony coverage was related to the complicated cases. Young age was found to be a favoring factor for total bony coverage over the implant.