FIXATION OF FRACTURED ORBITAL BONE USING AUTOGENOUS CALVARIAL BONE PLATE

Yang, Yun Seok

Abstract

In case of zygomatico-orbital complex fracture, due to the anatomic and physiologic complexity of the orbit, trauma can cause a variety of sequelae characterized by enophthalmos, diplopia, hypothalmos and so on. If enophthalmos should develope, one can perform autogenic or allogenic implants. Glass beads have been recommended but only in patients with nonseeing eyes. Implants of silicon, polyethylene, methylmethacrylate and teflon beads have been all described. Irradiated cartilage, autogenous cartilage and fascia have been reported but long-term results could be disappointing because of eventual resorption. The calvarial bone, among the autogenous materials, has been described as more optimal than other types of bone or materlals. After placement of autogenous implant into the orbit, one should manage the fractured zygomatic bone. The routine use of minlplates in oral and maxillofaclal surgery is now a commonly acutepted method of treatment after Champy and colleagues. The miniplate system is easy to use, allowes precise anatomic reduction, and in most cases, conventional maxillomandibular fixation is not necessary, thereby facilitating early recovery. However, complications of miniplates such as infection, wound dehiscence, corrosion, loosening of screw, discoloration of surrounding tissue and stress-shielding effect have been described. Even titanium alloys, which have been desribed as one of the least corrosion-resistant materials, have been reported to release metal into adjacent tissues and distant organs such as the lungs, spleen, liver, and kidneys. Late sequelae of miniplate fixation sometimes result in additional surgery for plate removal. Palpability and visibility, especially around the thin-skinned regions of the orbit, are of particular concern. There has been nearly no trial of designing autogenous calvarial bone plate. This plate would not show any foreignbody reaction, and hopefully it may be dessolved after finishing it's role as a plate, thereby eliminating additional surgery for plate removal. I, therefore, harvested additional calvarial bone to design the calvarial autogenous hopeplate for fixation of fractured orbit in case of zygomatico-orbital complex fracture combined with enophthalmos after harvesting of calvarial bone for surgical correction of enophthalmos. The result was not uneventful, so I report, therefore, harvested additional calvarial bone to design the calvarial autogenous hope plate for fixation of fractured orbit in case of zygomatico-orbital complex fracture combined with enophthalmos after harvesting of calvarial bone for surgical correction of enophthalmos. The result was not uneventful, so I report it.

FIXATION OF FRACTURED ORBITAL BONE USING AUTOGENOUS CALVARIAL BONE PLATE

Abstract

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