title: Quantitative assessment of medial orbit fracture repair using computer-designed anatomical plates.
abstract: BACKGROUND
  The purpose of this study was to objectively assess the accuracy of orbital reconstruction in patients with medial wall fractures following placement of computer-designed, prebent anatomical mesh plates by means of a transconjunctival-retrocaruncular approach.
  
  
  METHODS
  This was a retrospective, cohort study of consecutive subjects with facial trauma who underwent reconstruction of medial wall/orbital floor defects over a 12-month period at a level I trauma center. All subjects had preoperative and postoperative computed tomographic scans with 1.25-mm slices formatted in the axial, coronal, and sagittal planes with a minimum of 3 months' follow-up. Preoperative and postoperative orbital volumes were computed using integrated analysis over the orbital slices. The volumes were compared using nonparametric paired samples comparisons (Wilcoxon signed ranks test). For all analyses, p ≤ 0.05 was considered significant.
  
  
  RESULTS
  Fifteen subjects underwent repair of 17 medial wall fractures. The mean patient age was 37 ± 16 years (range, 18 to 59 years); one subject was female. Motor vehicle-related incidents and assaults were the most common mechanisms of injury. The average postoperative volume for the fractured sides was 22. 2 ± 2.1 cm3 (range, 19.9 to 26.9 cm3) and was statistically significantly lower than the preoperative volume on the fractured side (24.18 ± 2.57 cm3; p < 0.001). One patient (6.7 percent) experienced a postoperative complication requiring reoperation.
  
  
  CONCLUSIONS
  Computer-designed, prebent anatomical mesh plates placed using a transconjunctival-retrocaruncular approach for reconstruction of medial wall fractures with orbital floor components reliably results in restoration of contour and volume, with a low complication rate.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Baltimore, Md.; and Boston, Mass. From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, and the Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, and the Department of Surgery, Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital.
authors.forename: Chad R
authors.initials: CR
authors.lastname: Gordon
authors.forename: Srinivas M
authors.initials: SM
authors.lastname: Susarla
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Yaremchuk
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D005147:Facial Bones / Q000293:injuries; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012984:Software; D025321:Surgery, Computer-Assisted; D014025:Titanium; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D014025:Titanium