Microplate osteosynthesis of orbital floor fractures
| Autor: | O. Fakler, Ralf Schön, N. Weyer, Marc C. Metzger |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Diplopia
Osteosynthesis Miniaturization genetic structures Maxillary sinus business.industry Soft tissue Anatomy eye diseases Infraorbital nerve Fracture Fixation Internal medicine.anatomical_structure Otorhinolaryngology Fracture fixation Bone plate Medicine Transconjunctival approach Humans Surgery Oral Surgery medicine.symptom business Bone Plates Orbital Fractures Fractures Comminuted |
| Zdroj: | The British journal of oralmaxillofacial surgery. 45(2) |
| ISSN: | 0266-4356 |
| Popis: | We present the outcome of transconjunctival osteosyntheis with a microplate of orbital floor fractures when there is nly a single fragment. Four patients with dislocated orbital oor fractures and diplopia were treated by osteosynthesis f the fractures between January 2004 and February 2005. ll four patients had double vision particularly on extreme ownward and upward gaze. The type and location of fracture as established by preoperative computed tomography. Two patients were operated on immediately after the njury and two patients after 7–10 days because of extenive periorbital swelling on admission. Intraoperatively we ecided to use osteosynthesis of the fractures only when we ound a single displaced fragment larger than 1.5 cm2. For extensive fractures with multiple fragments or defects e reconstructed the orbital floor and retrobulbar bulge with itanium mesh. The aim of osteosynthesis was anatomical eduction after removal of displaced orbital soft tissues and ony fragments from the maxillary sinus. We exposed the rbital floor by a transconjunctival approach without cantholsis and located the infraorbital nerve before osteosynthesis o protect it. The orbital fragment was fixed in the anterior aspect of he orbital floor using 1.0 and 1.3 mm microplates (Synthes, aoli, USA). It is difficult to fix screws in the posterior or entral part of the orbital floor because of angulation of the rill and unreliable anchorage of screws in thin bone. The ragment of the orbital floor was reduced and supported from nderneath during drilling (at high speed and low pressure) ith Gilles or nerve hooks. After the plate had been fixed nto the fragment with the first screw the bone was accurately educed. Bending of the plate allowed for precise reconstruc |
| Databáze: | OpenAIRE |
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