Management of complex orbital fractures.

Fractures of the orbit place the globe and associated structures at significant risk. Management of these fractures requires a thorough ophthalmic evaluation and precise imaging. Contemporary surgical approaches allow the surgeon to repair these injuries with minimal secondary cosmetic deformities and should avoid injury to the globe. A principle goal of therapy is to anatomically reduce fracture segments and to restore a normal orbital volume. Reconstitution of a normal orbital volume and support for the globe will prevent post-injury enophthalmos and globe malposition. The evaluation, imaging, exposure, and repair of orbital fractures is reviewed. Prevention and management of complications is also discussed. The causes of and prevention of blindness is discussed. Application of these techniques should allow for the repair of orbital fractures in a single stage with minimal morbidity.