Surgical treatment of Blow-out fracture with titanium mesh: Case report

Abstract

Blow-out fractures are known to affect the floor or medial wall of the orbit, an anatomical region located in the middle third of the face. For an accurate diagnosis of this fracture, a thorough clinical examination associated with imaging is necessary, among them, multi-slice computed tomography is considered the “gold standard” for diagnosis and planning the approach to this type of fracture, as it allows visualization all structures without interferences, and also allowing the degree of bone comminution to be measured. Among the tomographic planes, the coronal section stands out for enabling a better assessment of the orbital floor and medial wall. Signs and symptoms are usually diplopia, enophthalmos, malar changes, restricted ocular mobility, infraorbital nerve paresthesia, periorbital ecchymosis. There are several types of surgical approaches for treating this type of trauma and to reconstruct blow-out fractures, alloplastic materials, autogenous or heterogenous grafts are chosen. The objective of this paper is to report a clinical case of blow-out orbital fracture, the surgical approach, reduction and fixation with a 1.5mm system mini-plate on the left infra-orbital rim and reconstruction of the left orbital floor with a titanium mesh, giving emphasis on the treatment of orbital floor fractures, with titanium mesh and the good prognosis without signs of contamination or postoperative foreign body reaction. Adequate clinical and anamnestic examination, plus imaging examination, followed by convergent planning, increases the chances of a good prognosis, always with the aim of achieving, when possible, the reconstruction of the form, function and aesthetics of the traumatized area.