Management of fractures of the supraorbital rim

The frequency of supraorbital rim fractures is increasing as incidence of motorcycle and bicycle accidents increases. These fractures are frequently depressed, comminuted, and often extend into the frontal sinus. Open reduction and fixation are the treatment of choice. Adequate debridement and cleansing with preservation of periosteum and blood supply are recommended. Unstable fragments can be fixed to the frontal bone or stabilized by suturing the torn periosteum. Severely comminuted supraorbital frontal sinus fractures may require stabilization via frontal sinus pack or balloon. We feel the latter is preferable and both Foley and Fogarty catheters have been successfully used.