Effectiveness of secondary post-traumatic periorbital reconstruction

In a 12-year period, 56 consecutive patients have undergone secondary periorbital reconstruction after trauma. To evaluate the overall results and the need for further correction, three diagnostic groups were formed. These were: malar bone (n = 16), midface (n = 16) and fronto-orbital fractures (n = 24). Also, in order to judge the reliability of the procedures used most frequently, all osteotomies of the zygoma (n = 32 in 30 patients), canthopexies (n = 26 in 19 patients) and corrections of the bony nasal skeleton (n = 26) were assessed as separate groups. After malar fractures, poor results were found in two cases while after midface fractures the results were quite satisfactory with only one poor result. The outcome after fronto-orbital fractures was also generally satisfactory. However, after a considerable number of later corrections there were still four poor results. Unfortunately, osteotomy of the zygoma left a rather high percentage of unsatisfactory results (19%), but canthopexies scored high and further corrections after secondary surgery of the nasal skeleton eliminated all but one poor result. It is concluded that 7% of our trauma patients undergo secondary and further periorbital corrections. The techniques have become routine. The final outcome was assessed as good in 60% and poor in 20% of patients.