Management of Pure Medial Orbital Wall Fracture With Autogenous Bone Graft

Abstract

The orbit is an irregular conical cavity formed from 7 bones including the frontal, sphenoid, zygomatic, maxillary, ethmoid, lacrimal, and palatine bones. Fractures of the internal orbit can cause a number of problems, including diplopia, ocular muscle entrapment, and enophthalmos. Although muscle entrapment is relatively rare, diplopia and enophthalmos are relatively common sequelae of internal orbital fractures. Medial orbital wall fracture is relatively uncommon and represents a challenge for its anatomical reconstruction. In this context, autogenous bone graft has been the criterion standard to provide framework for facial skeleton and orbital walls. Therefore, it is possible to harvest grafts of varying size and contour, and the operation is performed through the bicoronal incision, which is the usual approach to major orbital reconstruction. Thus, this article aimed to describe a patient with a pure medial orbital wall fracture, and it was causing diplopia and enophthalmos. The orbital fracture was treated using autogenous bone graft from calvarial bone. The authors show a follow-up of 12 months, with facial symmetry and without diplopia and enophthalmos. In addition, a computed tomography scan shows excellent bone healing at the anterior and posterior parts of the medial orbital wall reconstruction.

Facial Bone Reconstruction Using both Marine or Non-Marine Bone Substitutes: Evaluation of Current Outcomes in a Systematic Literature Review

“…After the study selection, a new division related to the kind of bone graft has been performed: Autlogous Bone: Thirteen studies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]; Homologous Bone: Five studies [ 29 , 30 , 31 , 32 , 33 ]; Xenograft or Allograft material and bone derived from animal or synthetic origin: Ten studies [ 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]; Marine collagen material: Eleven studies [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. …”

“…Autlogous Bone: Thirteen studies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ];…”

“…Evaluation on the total risk of bias for each selected paper, and the majority of the manuscripts were allocated as unclear risk [ 20 , 21 , 22 , 23 , 27 , 28 , 29 , 34 , 35 , 36 ]. Three research papers were considered as having a low risk of bias [ 32 , 37 , 39 ], where another one was classified as moderate risk [ 30 ].…”

“…Pereira Rdos et al analyzed the management of orbital fracture with autologous bone graft in their study. A computed tomography scan shows excellent bone healing at the anterior and posterior parts of the medial orbital wall reconstruction [ 28 ].…”

Correlation Between the Change in Orbital Volume and Correction of Enophtlamous in Delayed Post-Traumatic Cases

“…So much attention has been given to the bony reconstruction of the orbital walls. Calvarial bone grafts 5 , high density porous polyethylene alone 6 or with embedded titanium meshes 7 , polydioxanone 8 and titanium meshes 9 are among the most popular grafts and implants used for reconstruction. Optimizing the bony reconstruction using advanced techniques such as intraoperative imaging, navigation and computer-assisted planning have been reported over the past years 10,11 .…”