HINGED SILICONE COVERED METALLIC IMPLANT FOR REPAIR OF LARGE FRACTURES OF THE INTERNAL ORBITAL SKELETON

The objective of this study was to determine the effectiveness of hing ed silicone covered metallic implant for the repair of large fractures of the internal orbital skeleton. Twelve patients undenvent reconstru ction of the orbital floor (and medial wall) with a hinged silicone co vered metallic implant that was fixated at or just inside the inferior orbital rim with screws. The surgical technique permits intraoperativ e graded overcorrection because the implant is secured at the orbital rim and bent at its ''hinge'' to elevate the entire implant to the des ired height. Nine of 12 patients had late repairs (greater than or equ al to 4 weeks after injury); 3 patients had early repairs less than or equal to 3 weeks of injury. All 12 patients had acceptable results wi th regards to enophthalmos and hypoophthalmos. One patient underwent s econdary soft tissue upper eyelid augmentation for a residual superior sulcus deformity. The hinged silicone covered metallic implant is a u seful technique for reconstruction of large orbital floor and medial w all defects. Long-term complications of this implant are unknown.