Ergebnisse nichtfixierter Silikonimplante in der Versorgung der Blow-out-Fraktur und Orbitatrümmerfraktur

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Abstract
The number of difficult maxillofacial fractures increases with the number of traffic accidents; 80% of all accidents of this kind are accompanied by head injuries. In the treatment of combined blow-out-fracture and fracture of the orbit, the most important task is a repair of all orbital structures in collaboration of the ophthalmologist with the otolaryngolist and the oral surgeon. A knowledge of all orbital fractures (stages according to Bleeker) is an essential basic requirement. Bigger defects of the orbital walls may be closed with 1, 2 or 3 perforated silicone implants in accordance with Whyte. The open repair of the orbital ring with intraosseous fixation is the modern method of treatment of dislocated orbital bones. After a detailed description of an operative procedure, treatment results of 75 combined blow-out-fractures (among them 4 orbital fractures of the floor, walls, roof and margins) are given. The following complications are listed: 1 case of orbital hemorrhage, 36 cases of persistent lower lid edema, 4 cases of tissue reaction to the alloplast, 3 cases of infection (among them 1 otolaryngolical case) and 5 cases of implant extrusion.

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