Orbital Fracture Reconstruction Using Prebent, Anatomic Titanium Plates: Technical Tips to Avoid Complications

Orbital fractures are common. In patients where there is significant loss of the medial wall and orbital floor, anatomic prebent 3-dimensional plates allow efficacious restoration of orbital volume. However, the large size of these plates can result in technical difficulties with plate placement, especially in fractures with complete loss of 2 walls of the orbit. In this article, the authors review the pertinent anatomy of the bony orbit with respect to fracture and landmarks in fracture reduction. The authors also note the 3 most commonly encountered problems with the placement of anatomic plates: poor exposure, failure to identify the posterior ledge for the plate, and rotational issues with plate placement resulting in impingement. Technical tips are given to help overcome these issues intraoperatively. Address correspondence and reprint requests to Chad A. Purnell, MD, Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, 675N St Clair Street, Suite 19-250, Chicago, IL 60611; E-mail: chadpurnellmd@gmail.com Received 25 November, 2017 Accepted 16 February, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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