Comparison of ‘sutureless’ Transconjunctival and Subciliary Approach for Treatment of Infraorbital Rim Fractures: a Clinical Study

Abstract

The aim of the study is to compare subciliary incision and 'sutureless' transconjunctival incision in the treatment of infraorbital rim fractures. In this prospective study, 40 patients with fractures of the infraorbital rim were selected and divided into 2 groups using random sampling technique. Group A patients were treated using 'sutureless' transconjunctival technique and group B patients were treated using subciliary approach. The following parameters were compared a) time taken, intraoperative ease of access, exposure achieved; b) clinical outcome and postoperative complications; c) Aesthetic outcome at intervals of 15 days, 1 month and 3 months. Total time taken for completion of surgery was lesser in group A patients. The presence of subconjunctival ecchymosis (at 1 month interval) and neurological deficit was found to be statistically significant (P<0.05) in the 'subciliary' group of patients. The transconjunctival approach showed better esthetic results and fewer post-operative complications. The subciliary approach gives good exposure of the infra-orbital rim and is better suited to reduce extensively displaced fractures of the infra-orbital rim. The transconjunctival approach is comparatively faster, gives better esthetic results and fewer post-operative complications but is technique sensitive and requires an additional lateral canthotomy in cases where more exposure is needed.