Hinged silicone covered metallic implant for repair of large fractures of the internal orbital skeleton.

The objective of this study was to determine the effectiveness of hinged silicone covered metallic implant for the repair of large fractures of the internal orbital skeleton. Twelve patients underwent reconstruction of the orbital floor (and medial wall) with a hinged silicone covered metallic implant that was fixated at or just inside the inferior orbital rim with screws. The surgical technique permits intraoperative graded overcorrection because the implant is secured at the orbital rim and bent at its "hinge" to elevate the entire implant to the desired height. Nine of 12 patients had late repairs (> or = 4 weeks after injury); 3 patients had early repairs < or = 3 weeks of injury. All 12 patients had acceptable results with regards to enophthalmos and hypo-ophthalmos. One patient underwent secondary soft tissue upper eyelid augmentation for a residual superior sulcus deformity. The hinged silicone covered metallic implant is a useful technique for reconstruction of large orbital floor and medial wall defects. Long-term complications of this implant are unknown.