Operative Results in Orbital Floor Fracture Associated with Malar Tripod Fracture

Lee, Chang Hawn; Chang, Han Ki; Song, In Soo

Abstract

17 patients underwent operations in malar tripod fracture combined with orbital floor fracture from January 1995 to June 1998. Age distribution was from 16 to 62. Sexual distribution was 15 males and 2 females. 11 cases were due to slip or all down. All orbital floors were reconstructed with silastic sheet through subciliary incision. In case of type I and type II, one-point fixation was performed with miniplate and screws on zygomaticomaxillary suture, In type III and IV, two-point fixation was done with miniplate and screws on zygomaticomaxillary and zygomaticofroptal suture by Gillies' approach and lateral eyebrow incision. Among 9 patients with preoperative diplopia, 5 patients improved within 1 week, 2 patients within 1 month. Among 3 patients with severe preoperative diplopia, 2 patients remained with mild diplopia, but no interference with daily work was encountered. In postoperative apperance and X-ray findings, excellent results were noted in 4 cases(24%), good cases in 10 cases (59%), fair cases in 3 cases (18%), but no poor case was found. 5 cases with Preoperative mouth opening limitation improved during postoperative period. In patients with malar tripod fracture with orbital floor fracture, it can serve as a good surgical method that bony fragment reduction by Gillies' approach and fixation with miniplate and screws.