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@#AIM:To analyze the treatment of orbital Trapdoor fracture in children and the application of absorbable plate in surgery, so as to accumulate experience for clinical diagnosis and treatment.<p>METHODS: Retrospective analysis of 55 cases(55 eyes)orbital Trapdoor fractures in children. The fracture site was simple orbital floor fracture. All patients were approached by palpebral conjunctiva of lower eyelid. During operations, the embedded extraocular muscles and orbital tissues were returned. A resorbable implant was implanted into the orbit after trimming to proper sizes and shaped according to the fracture defect range. The therapeutic effect was evaluated by preoperative and postoperative ocular examination and orbital CT scan. Repeated measure analysis of variance was used to compare the differences of postoperative outcome evaluation indexes among patients with different operation timing.<p>RESULTS: No serious complications happened during and after surgeries in all patients. The postoperative CT scan showed that the fractures had good anatomical restoration. After the operation, diplopia and limitation of extraocular muscle movement(EOM)recovered obviously. The earlier the operation performed after the injury, the better the postoperative recovery effect was. At the same time, the resorbable implant could repair orbital Trapdoor fracture in children well. It serves as a better material of orbital fracture repairment.<p>CONCLUSION: Operation is an effective method to treat orbital Trapdoor fracture in children, and should be performed as soon as possible after injury. The resorbable implant is a good orbital repair material.
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@#AIM: To evaluate the clinical application of resorbable implants in orbital fracture repair surgery.<p>METHODS: A retrospective analysis of 48 eyes in 48 cases of orbital fracture, all patients were treated with resorbable implants for orbital fracture repair. During operations we exposed fully fracture defect range and returned the tissues that entered the paranasal sinus. A resorbable implant was trimmed to proper sizes according to the fracture defect range and fixed with 2 absorbable screws. The accuracy of plate positioning of the reconstructed orbit and the practicability of clinical use of resorbable implant were judged by the ophthalmic examination and computed tomography(CT)scan before and after operation. <p>RESULTS: All the patients completed the operation successfully and had no serious complications during or after surgery. All the patients had a good anatomical restoration by the postoperative CT scan. One year re-examination after operation, among 18 eyes with limitation of extraocular muscle movement(EOM)before operation 1 eye(6%)with limitation of EOM improved after surgery,17 eyes(94%)with limitation of EOM got cured. Among 30 cases with diplopia before operation 12 cases(40%)with diplopia improved after surgery, 18 cases(60%)with diplopia got cured. Among 32 eyes with enophthalmos before operation 10 eyes(31%)with enophthalmos improved after surgery, 22 eyes(69%)with enophthalmos get cured. Among 40 eyes with suborbital skin numbness before operation 33 eyes(82%)with suborbital skin numbness improved after surgery, 7 eyes(18%)with suborbital skin numbness got cured. Only one eye got lower eyelid entropion after surgery and was resolved by the second correction of entropion.<p>CONCLUSION: The resorbable implant can repair the fractures of orbital wall well. It is a better material of orbital fracture repairment.
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PURPOSE: BioSorbFX(R)(BIONX Implant Inc.) and Macropore(R)(Medtronics Inc.) are mesh-type resorbable copolymer plate. This report presents a new model necessary for orbital wall reconstruction, accoding to the operative outcomes of orbital fracture with its use. METHODS: A follow-up on 11 patients was performed to ascertain the operative effects of the mesh-type resorbable material for 6 months. RESULTS: The patients were 7 males and 4 females. The patients' average age was 29.7 years and the mean follow-up period was 8.1 months. The most common site of fracture was inferior wall. In these cases, simultaneous fracture of the medial wall and floor was frequently observed. One case showed limitation of ocular movement, diplopias and enophthalmos simultaneously; 3 cases, enophthalmos and diplopia; 5 cases showed limitation of ocular movement and diplopia; and 2 cases, considerable possibility or the presence of enophthalmos due to extended fracture size. The cases improved remarkably after being operated and none were observed to have worsened. Moreover, serious complications, such as visual loss, the infection of implants, dislocation, exposure, etc., were not observed. CONCLUSIONS: Altogether, it is considered that the mesh-type resorbable copolymer plate may be safely used in orbital wall reconstruction without conspicuous complication.