Surgical management of orbital fractures: Hospital de San José. 1997-2002 * Manejo quirúrgico de las fracturas orbitarias: Hospital de San José. 1997-2002 *

Abstract

We retrospectively reviewed 25 patients with orbital fractures, surgically treated at the Hospital de San José, by functional and / or aesthetic indication, between January 1997 and March 2002. Car accidents, along with aggression, were the most common (84%). The male sex was the most affected (84%). For the classification of fractures, the pure and impure system (Converse and Smith) was used, with predominance of the latter (88%). The approach was combined in 90% of the procedures, preferring the subciliary and transconjunctival floor of the orbit, and the classic approaches for the roof and lateral wall. For orbital reconstruction, titanium mesh was used in 13 patients, autologous grafts (septum, calotte, iliac crest and temporal fascia) in 11 individuals, and graft of bone bank in one. The presence of sequelae was related to the trauma and the method of reconstruction, as well as to the approach used and the time elapsed at the time of the intervention. 48% of the cases presented sequelae: scleral sample in six patients, followed by enophthalmos and diplopia in three. Only one of them (4%) warranted reoperation. The scleral sample was associated in five subjects with subciliary approach. None of the patients presented infection or rejection of the graft. All individuals with ocular dystopia in the postoperative period underwent reconstruction with autologous grafts.