Secondary post-traumatic periorbital surgery. Incidence and results.

Over a 6 year period 20 patients presented for secondary corrections of the periorbital region after trauma. Corrections after isolated fracture of the zygoma were necessary in 6 cases, mainly comprising re-osteotomies and contour corrections. A tertiary correction was needed only once (17%). Secondary treatment was indicated in 6 patients after fracture of the midface, necessitating mainly re-osteotomies of the zygoma, corrections of the nose and canthopexies. Tertiary corrections were performed in 3 cases (50%). In 8 patients the results of treatment of fronto-orbito-nasal fractures required further improvement. Again, osteotomies of the zygoma, corrections of the nose as well as corrections of scars and bony contours were often indicated. Four cases (50%) needed tertiary surgery. It is concluded that the more serious the primary trauma the greater the necessity for further secondary surgery. Independently of the kind of primary trauma the indication for secondary treatment was, in most cases, aesthetic. Not only was the number of re-osteotomies and nasal corrections high, but also the number of tertiary revisions. While this might not be very surprising for the nose, it is for the zygoma and proves the difficulties which arise for perfect positioning when there are no clear landmarks. Forty percent of all patients underwent tertiary and one patient needs a quaternary correction.