Growing Beyond Static Reconstruction: A Custom Expansile Orbital Implant in a Pediatric Patient

Reconstruction of pediatric orbital fractures remains challenging because currently available implant options do not accommodate ongoing craniofacial growth. We describe the use of a customized growth-adaptive implant for reconstruction of the lateral orbit following a complex blowout fracture in an 8-year-old girl. A custom 2-piece polyetheretherketone (PEEK) implant with a stair-step sliding mechanism and resorbable fixation was designed to allow passive expansion with continued orbital growth. At 3-month follow-up, the patient demonstrated preserved binocular vision, intact extraocular movements, no persistent diplopia, and only mild residual enophthalmos. This case highlights a novel growth-adaptive implant paradigm for pediatric orbital reconstruction that may reduce the need for revision surgery as the craniofacial skeleton matures.