Orbital floor injuries are among the most frequent midface traumas. Due to improved diagnostic and planning procedures, there has been a significant rise in patient expectations in recent years.
This was reason enough for the S.O.R.G. trauma section to develop in close collaboration with KLS Martin a specific treatment set covering the complete range of orbital floor defects as defined by the international classification according to Jaquiéry et al.
Jaquiéry differentiates between the following defect classes:
Treating surgeons are often confronted with the basic question whether resorbable materials or titanium implants should be used for reconstructing a given orbital trauma. So at a first step a thorough investigation on the predominant treatment patterns of all S.O.R.G. trauma section members was carried out in order to find a common treatment algorithm.
It became obvious that Class I and Class II defects are well suited to using resorbable materials. They also represent the great majority of orbital injuries. Class III defects are limit cases, and Class IV cases should rather not be treated on a resorbable basis due to poor bone texture quality.
New resorbable implants
Especially for these small size defects, a new generation of resorbable implants has been designed.
The geometry of the orbital floor is not straight, but follows its own, curved form ("lazy-S geometry"). To achieve optimal reconstruction results, the selected implant needs to be exactly adapted to this idiosyncratic geometry – irrespective of whether it is resorbable or titanium.
By collecting and projecting a great variety of CT scans, it was possible to develop an orbital forming device reflecting the average form and size of an adult European, thus allowing the selected implants to be preshaped prior to using them on patients. The orbital forming device can be steam-sterilized repeatedly.
New titanium implant
Extensive orbital injuries can take very different forms. Therefore, it must be possible to cut the selected titanium implants exactly to size to adapt them as perfectly as possible to the condition to be treated. Sharp edges and projecting burrs must be avoided under any circumstances. Consequently the section has optimized the existing orbita floor implants with regard to find more and better cutting options, in length as well as in width.