Damaske E
Ophthalmologica. 1978;176(4):220-9. doi: 10.1159/000308742.
The number of difficult maxillofacial fractures increases with the number of traffic accidents. 80% of all accidents of this kind are accompanied by juries of the head. In the treatment of combined blow-out-fracture and fracture of the orbit, the most important task is a repair of all orbital structures in collaboration of the ophthalmologist with the otolaryngolist and the oral surgeon. A knowledge of all orbital fractures (stages according to Bleeker) is an essential basic requirement. Bigger defects of the orbital walls are closed by me with one, two or three perforated silicon implants in accordance with Whyte. The open repair of the orbital ring with intraosseous fixation is the modern method of treatment of dislocated orbital bones. After a detailed description of my own operative procedure the treatment results of 75 combined blow-out-fractures--among them 4 orbital fractures of the floor, walls, roof and margins--are given. The following complications are listed: 1 case of orbital hemorrhage, 36 cases of persistent lower lid edema, 4 cases of tissue reaction to the alloplast, 3 cases of infection )amoung them one otolaryngolical case) and 5 cases of extrusion of the implant.