Contour Restoration of the Secondary Deformities of Zygomaticoorbital Fractures With Porous Polyethylene Implant

Abstract

Inappropriate treatment or untreated fractures of the zygomaticoorbital area results in secondary deformities such as loss of malar projection, enophthalmos, and dystopia. Secondary deformities can be corrected with osteotomies, contour restoration, or a combination of both. Contour restoration can be performed with using onlay grafting with autogenous material or alloplastic implants. In this study, mild to moderate secondary deformities of zygomaticoorbital fractures were corrected with porous a polyethylene implant, which is a highly biocompatible, durable, and stable material. The number of patients who have no surgical treatment at the time of their initial injury was 15, whereas the number of patients who have an initial treatment that resulted in secondary deformities was seven. Twelve of 15 patients had only loss of cheek projection and three of the 15 patients had dystopia and loss of cheek projection. The remaining seven patients had secondary deformities resulting from skeletal surface contour abnormality as a result of comminuted fractures. In 17 of the patients, we used a subciliary approach while using the old incision scar for access in the remainder. In 22 patients, 24 implants were used. Porous polyethylene implant was carved outside in according to the existing contour deficit and was placed in the subperiosteal plane and fixed with titanium screws. The mean follow-up period was 13 months (range, 6-24 months). In this follow-up period, there was no implant extrusion, exposition, infection, or any complication resulting from subciliary incision. Patients were satisfied with the results. The best result can be achieved with porous polyethylene implant in contour restoration of mild to moderate secondary deformities of zygomaticoorbital fractures. The use of this implant in the zygomaticoorbital area is safe and has minimal morbidity.