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.
Noda
Mika
M
Department of Ophthalmology, Hokkaido University School of Medicine, Sapporo, Japan.
Noda
Kousuke
K
Ideta
Shinji
S
Nakamura
Yasuhisa
Y
Ishida
Susumu
S
Inoue
Makoto
M
Tsubota
Kazuo
K
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