Repair of blowout orbital floor fracture by periosteal suturing.
The study objective was to evaluate the outcome of a periosteal suturing technique in eyes with orbital blowout fractures. Fifteen orbital floor fractures were classified into: type 1, linear fracture; type 2, middle fracture; and type 3, posterior fracture extending two-thirds into the orbit. The feasibility of periosteal suturing without silicone plates or one of minimal size was determined. The improvement of ocular movements and surgical complications were evaluated. A complete suture of the torn periosteum without implanting a silicone plate was achieved in 2/2 (100%) type 1 cases, 5/7 (71%) type 2 cases and 0/6 (0%) type 3 cases. A partial fixation was achieved in 3/6 (50%) type 3 cases with an implantation of a silicone plate of approximate one-third of the usual size in one case. Conventional surgery with silicone plates after failed periosteal suture was required in 2/7 (29%) type 2 cases and 3/6 (50%) type 3 cases. Eye movements were improved postoperatively in all eyes, and a complete range of eye movements was achieved in 6/7 (86%) cases with complete periosteal closure, 1/3 (33%) of cases with partial closure and 2/5 (40%) cases without closure. In conclusion, periosteal suturing can minimize the need for silicone plates especially for anterior or middle orbital floor factures.
Department of Ophthalmology, Hokkaido University School of Medicine, Sapporo, Japan.
Mika
M
Noda
Kousuke
K
Noda
Shinji
S
Ideta
Yasuhisa
Y
Nakamura
Susumu
S
Ishida
Makoto
M
Inoue
Kazuo
K
Tsubota
D000293:Adolescent; D000328:Adult; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D009917:Orbital Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D010521:Periosteum / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D019736:Prostheses and Implants; D011859:Radiography; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult