Abstract Listings 2024

Purpose

Fractures occur when there is impact to the orbit from an object larger than the orbital rim. The force of impact is transferred to weak points of the orbit: posteromedial floor (parallel to infraorbital nerve) and medial wall. There are many techniques and materials in the literature for repairing the orbital floor, each have their advantages and disadvantages. We present a case series of patients with orbital floor repair using patient-specific solid titanium implants (PSI).

Methods

This is a retrospective case series. Cases were identified by obtaining a list of patients for whom our prosthetics department had made PSIs between 2019-2023. Their notes were obtained to ascertain patient demographics, nature of injury, time to surgery, signs and symptoms pre- and post-operatively and length of follow up.

Results

21 patients were included, 13 were male and 8 female. Mean age was 43, range 12-80. Nature of injury included fall (n=8), assault (n=6), sport related injury (n=6) and road traffic accident (n=1). The most common reason for surgery was muscle entrapment on CT (n=13). The average time to surgery was 48 days (range 5-195). All patients had partial or complete improvement of diplopia with the near vertical measurements showing the most significant improvement, going from 5.6 prism dioptres on average pre-operatively to 1.6 PD post-operatively.

Conclusion

Our results demonstrate a good outcome following insertion of solid titanium implants for orbital floor fracture repair. Post-COVID recovery meant that cases were operated on later than the ideal timeframe reported in the literature, however this does not seem to have resulted in adverse outcomes for the patients. To our knowledge this is the largest series in the UK of outcomes from solid titanium PSIs used to repair orbital floor fractures.

Additional Authors

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