Comparison of the Efficacy of Transconjunctival Incision with Lateral Canthotomy and Intraoral Vestibular Incision for Management of Infra-orbital Rim Fracture

Abstract

Background: The treatment of an infraorbital rim fracture necessitates careful consideration. There several different techniques which are implicated with exposure of the infraorbital rim having its own sets of merits and demerits. Here, we intend to compare two incisions used for the management of fracture of the infraorbital rim.
 Objectives: The focus of this study is to compare and analyze the efficacy of transconjunctival and intraoral incisions in terms of time taken for fracture exposure, adequacy of exposure and fixation, and post-operative complications such as soft tissue injury, chemosis, infraorbital nerve paresthesia, ectropion, scleral show, lagophthalmos, and wound dehiscence.
 Methodology: Two groups with 10 patients requiring open reduction and internal fixation of infraorbital rim fracture in each group will be included in the study. The patients will be divided randomly into Group A consisting of patients undergoing open reduction and internal fixation using transconjunctival incision or Group B consisting of patients undergoing open reduction and internal fixation using intraoral incision. The two approaches will be compared on the basis of time taken for exposure of fracture site, adequacy of exposure and fixation and post operative complications like soft tissue injury, chemosis, infraorbital nerve paresthesia, ectropion, sclera show, lagophthalmos and wound dehiscence.
 Expected Results: The efficacy of intraoral incision would be better than transconjunctival incision as it would lead to lesser post operative ocular complications like chemosis, ectropion etc.

Vestibular versus trans-conjunctival approaches in open reduction and internal fixation of infraorbital rim fracture: A randomized clinical trial.

“…Recently, this approach was presented as alternative for the extraoral approaches for infraorbital rim fixation by limited studies 5,[8][9] . Furthermore, limited studies have been conducted to compare it to different extraoral approach 10 . Thus, the aim of this study was to compare the vestibular intraoral approach to transconjunctival approach for open reduction and internal fixation of infraorbital rim fracture.…”