title: Nylon foil (supramid) orbital implants in pediatric orbital fracture repair.
abstract: OBJECTIVE
  To present the authors experience with the nylon foil (Supramid) implant as a safe and effective method to repair pediatric orbital wall fractures.
  
  
  METHODS
  A retrospective chart review of all pediatric patients (≤18 years) that underwent orbital wall fracture repair with an unsecured 0.4-mm Supramid implant between 2007 and 2010. Outcome variables were diplopia and surgical complications. This study was carried out with IRB approval.
  
  
  RESULTS
  A total of 59 orbits in 57 patients underwent orbital fracture repair using solely the 0.4-mm Supramid implant that were included in this retrospective chart review with the average age being 12 years. Trauma related to daily activities (42.1%) was the most frequent cause of orbital fractures. Eight patients (14.0%) had associated ocular/orbital injuries. Thirty-one patients (54.8%) were symptomatic at presentation with the most common presenting symptom being diplopia (n = 19, 33.3%). The most common fracture pattern sustained was combined orbital floor and medial wall fractures, which occurred in 21 patients (36.8%). Of the 3 patients (5.3%) that required immediate intervention due to extraocular muscle entrapment resulting in vasovagal responses, all returned to full and normal extraocular motility. There were 2 postoperative complications without any permanent sequelae; no patient developed postoperative enophthalmos recognizable by both physician and parents, and diplopia improved in all the 6 patients who suffered from immediate postoperative diplopia (10.7%).
  
  
  CONCLUSIONS
  The nylon foil implant is a safe and effective method to repair pediatric orbital wall fractures given the low complication rate.
authors.affiliation: *Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, University of Kentucky; †Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, University of Louisville; ‡Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, University of Tennessee; and §Department of Ophthalmology, Oculofacial Plastic and Orbital Surgery, Indiana University.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Timoney
authors.forename: Mark
authors.initials: M
authors.lastname: Krakauer
authors.forename: Byron N
authors.initials: BN
authors.lastname: Wilkes
authors.forename: H B Harold
authors.initials: HB
authors.lastname: Lee
authors.forename: William R
authors.initials: WR
authors.lastname: Nunery
mesh_terms: D000293:Adolescent; D002209:Caprolactam / Q000031:analogs & derivatives*; D002648:Child; D002675:Child, Preschool; D004172:Diplopia / Q000534:rehabilitation; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D009917:Orbital Fractures / Q000601:surgery*; D020273:Orbital Implants; D011108:Polymers; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011108:Polymers; C009916:nylon 6; D002209:Caprolactam