Bioresorbable poly-L/DL-lactide (P[L/DL]LA 70/30) plates are reliable for repairing large inferior orbital wall bony defects: a pilot study.
OBJECTIVE
The purpose of this study was to share our clinical experience on the use of bioresorbable poly-L/DL-lactide implants (P[L/DL]LA) 70/30 (PolyMax; Synthes, Oberdorf, Switzerland) to repair, large (> or =2 cm2), inferior orbital wall defects and to evaluate whether P(L/DL)LA 70/30 implants adequately support the orbital soft tissue contents.


METHODS
Thirteen patients who suffered orbital blowout fractures, with > or =2 cm2 bony defects in the inferior orbital wall, took part in the study. The inferior orbital wall was explored via subconjunctival approach. After repositioning of orbital content, each inferior orbital wall was reconstructed using a round plate of P(L/DL)LA 70/30. Computed tomography and magnetic resonance imaging coronal sections were undertaken before the operation and 2 and 36 weeks postoperatively.


RESULTS
The magnetic resonance imaging studies showed no abnormal tissue foreign body reactions in the orbital region. The material showed adequate strength to stabilize bone segments during the critical period of bone healing. The bone healing seems to take place along the bone fragments. The clinical outcome was excellent in 11 of the 13 cases (85%). At the end of the study, only one patient had mild enophthalmos.


CONCLUSIONS
Bioresorbable P(L/DL)LA 70/30 implants are safe and reliable for the repair of large defects (> or =2 cm2) in the inferior orbital wall. It seems that this is the first reported biodegradable material, in the literature, to promote bone healing along the bone fragments of the inferior orbital wall.
Al-Sukhun
Jehad
J
Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland. Jehad.Al-Sukhun@hus.fi
Törnwall
Jyrki
J
Lindqvist
Christian
C
Kontio
Risto
R
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D015841:Enophthalmos / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000517:prevention & control; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000601:surgery; D009917:Orbital Fractures / Q000601:surgery*; D010865:Pilot Projects; D011091:Polyesters; D011183:Postoperative Complications; D015642:Radiology, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D011091:Polyesters; C033616:poly(lactide)