Alternative Treatment for Blow-In Fracture of Lateral Orbital Wall: Removal of the Fractured Fragment.

Blow-in fracture of the zygomaticomaxillary complex that was displaced into the orbital cavity could be associated with ophthalmologic injuries, ranging from visual acuity to ocular motility limitation. Appropriate reduction and realignment of the fractured bone is necessary as early as possible for recovery of function and esthetics. However, limitation of accessibility and visibility makes it difficult for delicate surgery and increases the risk of damage of adjacent anatomic structures, such as optic nerve and extraocular muscles. In this report, the removal of fractured fragment was carried out in 2 patients showing limitation of gaze via orbital rim approach to avoid aggressive surgery and reduce the possibility of injury of vital structures. The postoperative process was uneventful and there were no complications associated with removal of displaced lateral wall. In conclusion, the authors propose that the removal of the fragment that was medially displaced lateral wall of the orbit is a simple and safe method as an alternative treatment in a difficult situation of reduction surgery.