Severe orbital floor fractures: repair with a titanium implant

Summary

Fractures of the orbital floor which require exploration are usually treated with an alloplastic floor implant or an autogenous bone graft. When large portions of the orbital floor, together with the lower parts of lateral and medial walls, are destroyed there may be no possibility of providing a conventional orbital floor reconstruction. In this situation, a titanium orbital floor implant may well be required to support the globe. 4 cases of traumatic orbital floor blow-out fractures are described. Clinically, all patients had diplopia, enophthalmos and radiological evidence of extensive loss of the orbital floor. A titanium orbital floor implant was molded and secured to the infraorbital rim with miniscrews to reconstruct the orbital floor and to reconstitute the orbital volume. No additional bone grafting was performed. Complications were minimal. From this experience, in severe orbital floor fractures, good results are obtained by supporting the globe using only a titanium implant.