Fronto-orbital bone fracture: management and outcome

Abstract

ObjectiveThe aim of this study was to review the effect of early and late surgical intervention and armamentarium used on the functional and esthetic outcome of fronto-orbital fracture repair.BackgroundOrbital roof fractures represent an important group of orbital fractures because of their close relation to the frontal lobe of the brain and also because of their relation to the eye. Management of orbital roof fractures requires good assessment, early reconstruction, if possible, and team management. Functional and esthetic outcomes should be assessed.Patients and methodsTwelve patients with orbital roof and frontal bone fractures were included in this study. Surgical treatment included open bone reduction alone, open reduction with fixation, and/or orbital reconstruction. Postoperative assessment of functional ocular deformities (limited eye movement and diplobia) and esthetic deformities (enophthalmos, dystopia, and proptosis) was carried out. Radiologic assessment for bone reduction and orbital volume was carried out.ResultsAll patients were males. They ranged in age from 16 to 61 years. Road traffic accidents were the cause of trauma in about 67% of patients. Early intervention was performed in 50% of patients, with 100% correction of functional deformities, 90% correction of esthetic deformities and accurate bone reduction in 95% of cases, and good patient satisfaction in 85% of cases. This was much better than late intervention. Titanium mesh was used in 50% of the cases, with accurate orbital volume reduction in 90% of the cases, which was only 50% with bone graft use.ConclusionEarly management of orbital roof and frontal bone fractures yields the best results. The use of titanium mesh leads to good functional and esthetic outcomes, with no donor-site morbidity, and saves time.