Treatment of orbital fractures: the case for reconstruction with autogenous bone.

d d s a ecause of the complex structure of the orbital walls, he fracture patterns vary considerably in their locaion as well as in their degree of severity.1 Multiple ortions of the orbit can be fractured and several nternal orbital walls therefore injured simultaeously. The ideal reconstruction material for orbital floor or all reconstruction should be easy to mold, easy to nchor, biocompatible, strong, and readily available. t should restore orbital form and support function. ut is that enough? Orbital wall fracture implies a situation where disuptions of the walls or floor have occurred. It is a efect fracture where bone fragments with torn peristeum are pushed outside of the original bony orbit. here is no intact bone even near the defect area xcept the thin bone rim surrounding the defect racture. The purpose of defect repair is to support rbital contents, free entrapped tissue, and, espeially, restore the original orbital volume. If the volme cannot be restored, enophthalmos will inevitably ccur.2 Even a 5% change in volume leads to clinically etectable changes in soft tissue position, resulting in nophthalmos.3 The treatment of choice to restore absent bone egments in facial skeleton is to replace the defect ith autogenous bone. Alloplastic materials have een used with caution, because they increase the isk of infection and have the potential for extrusion. hy should the treatment of orbital wall defect fracures differ from this general opinion?