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10.5999/aps.2015.42.4.424

http://scihub22266oqcxt.onion/10.5999/aps.2015.42.4.424
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C4513050!4513050!26217562
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suck abstract from ncbi


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pmid26217562      Arch+Plast+Surg 2015 ; 42 (4): 424-30
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  • Combined Orbital Fractures: Surgical Strategy of Sequential Repair #MMPMID26217562
  • Hur SW; Kim SE; Chung KJ; Lee JH; Kim TG; Kim YH
  • Arch Plast Surg 2015[Jul]; 42 (4): 424-30 PMID26217562show ga
  • Background: Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. Methods: We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. Results: In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. Conclusions: We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon.
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