Accuracy and Predictability in Use of AO Three-Dimensionally Preformed Titanium Mesh Plates for Posttraumatic Orbital Reconstruction
| Autor: | Martin Broome, Bertrand Jaques, Paolo Scolozzi, Joris Heuberger, Elene Andersen, Andrej Terzic, Armen Yves Momjian |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty genetic structures chemistry.chemical_element Surgical Mesh Prosthesis Design Orbital Fractures/*surgery Computed tomographic Fracture Fixation Internal Imaging Three-Dimensional Postoperative Complications Prosthesis Fitting Humans Medicine Prospective Studies Orbital Fracture Orbital Fractures Aged Titanium Diplopia Orbital wall ddc:617 business.industry General Medicine Middle Aged eye diseases Surgery Fracture Fixation Internal/*instrumentation Treatment Outcome medicine.anatomical_structure Otorhinolaryngology Orbital reconstruction chemistry Coronal plane Bone Plates Female sense organs medicine.symptom Tomography X-Ray Computed business Nuclear medicine Software Orbit (anatomy) |
| Zdroj: | Journal of Craniofacial Surgery, Vol. 20, No 4 (2009) pp. 1108-1113 |
| ISSN: | 1049-2275 |
| Popis: | The aim of this study was to prospectively evaluate the accuracy and predictability of new three-dimensionally preformed AO titanium mesh plates for posttraumatic orbital wall reconstruction.We analyzed the preoperative and postoperative clinical and radiologic data of 10 patients with isolated blow-out orbital fractures. Fracture locations were as follows: floor (N = 7; 70%), medial wall (N = 1; 1%), and floor/medial wall (N = 2; 2%). The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures. A three-dimensional preformed AO titanium mesh plate (0.4 mm in thickness) was selected according to the size of the defect previously measured on the preoperative computed tomographic (CT) scan examination and fixed at the inferior orbital rim with 1 or 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative CT scan. Coronal CT scan slices were used to measure bony orbital volume using OsiriX Medical Image software. Reconstructed versus uninjured orbital volume were statistically correlated.Nine patients (90%) had a successful treatment outcome without complications. One patient (10%) developed a mechanical limitation of upward gaze with a resulting handicapping diplopia requiring hardware removal. Postoperative orbital CT scan showed an anatomic three-dimensional placement of the orbital mesh plates in all of the patients. Volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 2.5 cm(3). There was no significant difference in volume between the reconstructed and uninjured orbits.This preliminary study has demonstrated that three-dimensionally preformed AO titanium mesh plates for posttraumatic orbital wall reconstruction results in (1) a high rate of success with an acceptable rate of major clinical complications (10%) and (2) an anatomic restoration of the bony orbital contour and volume that closely approximates that of the contralateral uninjured orbit. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|