Aspects of orbital floor fracture repair

Trauma to the face may result in fracture of the maxillary floor and the passage of some of the ocular contents into the maxillary antrum. In some cases, the impaction of the extrinsic ocular musculature results in an annoying diplopia. In others, the maxillary fracture may involve not only the orbital floor, but also extend into the anterior maxilla with additional facial deformities. Surgical corrections of some of these fractures have utilized bone grafts from the anterior iliac crest to the orbital floor. In others, flat Teflon plates have been inserted along the line of the orbital floor fracture after any impacted orbital contents have been freed from the fracture. Both of these remedies suffer from disadvantages. The authors have utilized specially prepared and shaped plastic plates which have been inserted along both the bony orbital floor and the anterior maxilla. These reduce the possibility of displacement and extrusion of the implanted plastic prosthesis. Particularly in major osseous deformities, the functional and cosmetic results have been most gratifying. This technique may also be modified in patients who have coincidentally suffered the additional loss of the eyeball as a result of the injury and include an orbital implant.