안와벽 골절 재건시 medpor sheeting의 흡수성 나사 교정의 유용성

Abstract

The treatment and the operation timing for blowout fracture have been controversial, but resently most surgeons advocate early operative treatment for better postoperative results and decreased incidences of diplopia and enophthalmos. The purpose of this study is to evaluates the effectiveness of internal fixation method of Medpor？？ implant with BioSorbTMFX screw which is used for prevention of enophthalmos in posteriorly extended large orbital floor and medial wall fracture using subcillary approach. From Jan. 2007 to Dec. 2008, 80 patients who were diagnosed with posteriorly extended large orbital floor and medial wall fractures were classified into two groups. One group had undergone reduction surgery with regular Medpor？？ sheets without any fixation method, while the other group had their Medpor？？ sheets fixed with the BioSorbTMFX screws. The two groups were evaluated by comparison of their enophthalmos degree and effectiveness and other complications. In the non-fixation group, nine pationts had enophthalmos postoperatively. In postoperative CT examination, displacement of Medpor？？ implant with soft tissue impaction into maxillary sinus and orbital medial wall was observed in the patients. In the screw fixation group, twenty one patients had enophthamos preoperatively, five patients had enophthalmos postoperatively. but none of them suffer from complication such as soft tissue impaction , muscle entrapment or optic nerve compression postoperatively. Internal fixation method of Medpor？？ implant with BioTMFX screw on the medial surface of orbital floor provides firm stabilization of implants and surrounding soft tissues and can be an effective option especially when postoperative implant displacement or malposition was expected.