Reconstruction of Orbital Floor Fractures with Porous Polyethylene Implants: A Prospective Study

Abstract

Purpose The main aim of our study was to assess and evaluate the efficacy, long standing outcome and infection of porous polyethylene implants in treatment of orbital floor fractures. Patient and methods Twelve patients with fractures of orbital floor were included in the study. The cause of fracture was road traffic accident, self fall and cow hit respectively. They also complained of enophthalmos (n = 9), diplopia (n = 3), restricted eye movement (n = 2), impairment of infraorbital nerve (n = 3) and dystopia (n = 6). All the fractures were reconstructed with thin porous polyethylene sheets. Results No implants were extruded and there were no signs of inflammatory reactions against porous polyethylene implant. In all nine patients with pre-op enophthalmos it was corrected post-operatively with p value = 0.000 and was statistically significant; diplopia in one patient was corrected; persistence of double vision was noted in two patients. Restricted eye movement was corrected in all patients, dystopia was corrected in four patients and in two patients have persisting dystopia. Paresthesia persisted in all three patients. Conclusion Our experience was that reconstruction of orbital floor fracture using porous polyethylene implant is reliable, safe and effective and may be used for reconstruction of the orbital floor fracture with no donor site morbidity.

Clinical Outcome Following Surgical Repair of Small Versus Large Orbital Floor Fractures Using Polyglactin 910/Polydioxanone (Ethisorb®)

“…Although undeniable progress in the management of orbital floor fractures has occurred over the past decades, there is still a lack of broad consensus as to which material(s) should be used to restore proper anatomy of the orbital floor in order to achieve best clinical results. This is also reflected by the still very high number of recent studies describing various approaches and materials to reconstruct the orbital floor, such as titanium meshes [27], partially absorbable meshes [28], bioresorbable implants [29,30], resorbable collagen membranes [31], polydioxanone foils [32], porous polyethylene sheets [33], bioactive glass S53P4 implants [34], auricular conchal grafts [35], rib bone grafts [36], or heterologous cortical bone [37].…”

Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population

“…The use of 3D CAD/CAM to manufacture a custom implant has thus recently become a popularly researched technique [24,25] and studies have shown decreased complication rates and improved accuracy. When applied to a pediatric patient in this study, the same results were found.…”

Current Management of Late Posttraumatic Enophthalmos

“…High-density porous polyethylene is biocompatible, creating minimal surrounding soft-tissue reaction; has high tensile strength; and is nonresorbable. 72,73 The main disadvantage of high-density porous polyethylene is that it is not easily visible on postoperative computed tomographic scans. Composite implants, made of high-density porous polyethylene with embedded titanium mesh, combine the qualities of both materials and improve radiographic visualization of the implant.…”