Reconstruction of orbital floor blow-out fractures with silicone implant.
OBJECTIVE
To evaluate the outcome of orbital floor blow-out fractures treated surgically with silicone implant.


METHODS
The patients were examined in a prospective study from October 1993 to December 1999. Over this period 11 patients were diagnosed as having orbital floor blow-out fractures. The study was restricted to those who were both treated surgically and followed-up at least three months after the discharge from hospital. Only six patients (five males and one female), ranging in age from 6 to 30 years, fulfilled the inclusion criteria. The fractures occurred during brawls in 3 patients, car accidents in 2 patients and child's play in 1 patient. The diagnosis was based on history, clinical grounds and coronal computed tomography. The surgical procedure was the same in all patients, using silicone implant to reconstruct the defects. The mean follow-up time after surgery was 4.8 months.


RESULTS
The interval between injury and diagnosis ranged from 6 to 85 days (mean: 34.8 days). Limitation of vertical eye movements was present in all 6 patients, diplopia in 4 patients, enophthalmos in 3 patients and hypoesthesia in the distribution of the infraorbital nerve in 1 patient. The mean interval time between injury and surgery was 55.3 days and the majority of the patients (83%) had late repairs (> 14 days) after injury. Postoperatively, satisfactory results were obtained with regard to limitation of vertical eye movements, diplopia, enophthalmos and hypoesthesia. Only one patient had a persistent and partially reduced enophthalmos. Silicone implant was well tolerated in all 6 cases since complications such as infection, tissue reaction and extrusion were not observed.


CONCLUSIONS
Satisfactory results may be obtained after late repair of orbital floor blow-out fractures. Silicone implant has the potential to be used successfully in orbital floor fractures.
Mwanza
J C
JC
Department of Ophthalmology, University Hospital of Kinshasa, Kinshasa, Dem. Rep. of Congo. Jean-Claude.Kasongo@student.uib.no
Ngoy
D K
DK
Kayembe
D L
DL
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009917:Orbital Fractures / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants; D012828:Silicones; D016896:Treatment Outcome
D012828:Silicones