Long Term Results Following Immediate Reconstruction of Orbital Fractures: A Critical Morphometric Analysis

Abstract

M Dawar, OM Antonyshyn. Long term results following immediate reconstruction of orbital fractures: A critical morphometric analysis. Can J Plast Surg 1993; 1(1):24-29. The purpose of this study is to review the long term morphological results following primary reconstruction and bone grafting of orbital fractures. All patients presenting to the Victoria General Hospital in Halifax, Nova Scotia between July 1988 and December 1990 with orbital fractures of sufficient severity to require immediate reconstruction were included in the study. The series consists of 39 fractured orbits in 29 patients. In all patients, a standardized data sheet was used in recording patient demographics, and clinical and intraoperative findings. The surgical management of orbital fractures and in particular the redraping of periorbital soft tissues was performed according to a standard protocol. Long term morphometric assessment was performed between 11 and 38 months postoperatively, with a mean follow-up of 27 months. A McCoy facial trisquare and Hertel exophthalmometer were used in the anthropometric evaluation of ocular globe position and position of the periorbital soft tissue landmarks. Postoperative assessment of globe position revealed a 5% incidence of enophthalmos and an 11 % incidence of hyperophthalmia. Minor asymmetries in globe position measuring less than 2 mm were noted in a further 61 % of patients. Ectropion was documented in 8% of patients, but an asymmetry in the height of the palpebral fissure was noted in a further 34% of patients. In terms of canthal relations, lateral canthal dystopia was the most commonly observed deformity, with vertical dystopia occurring in 18% of patients and transverse dystopia in 33% of patients. The observed sequelae and complications of orbital fractures are discussed and possible causative factors identified.