Primary reconstruction of orbital fractures using patient-specific titanium milled implants: the Helsinki protocol

• Main Authors: Kärkkäinen, M. (Author), Mesimäki, K. (Author), Snäll, J. (Author), Wilkman, T. (Author)
• Format: Article
• Language: English
• Published: Churchill Livingstone 2018
• Subjects: adult; Adult; aged; Aged; Article; clinical article; cohort analysis; computer assisted tomography; devices; diagnostic imaging; diplopia; facial fracture; female; Female; follow up; Fracture Fixation, Internal; human; Humans; male; Male; middle aged; Middle Aged; orbit fracture; orbit implant; orbit reconstruction; orbital fracture; Orbital Fractures; Orbital Implants; osteosynthesis; patient specific implant; prosthesis design; Prosthesis Design; prosthesis dislocation; reoperation; Retrospective Studies; retrospective study; strabismus; titanium; Titanium; Tomography, X-Ray Computed; treatment outcome; Treatment Outcome; virtual planning; visual field; x-ray computed tomography; young adult
• Online Access: View Fulltext in Publisher

 Preoperative virtual planning and the use of patient-specific implants enable exact reconstruction of orbital fractures. We present our results and experience of reconstruction of isolated orbital fractures with patient-specific implants, according to the Helsinki protocol, in 15 patients who were followed up for at least three months postoperatively. The mean (range) difference between the positions of virtually planned, and postoperative, implants was 1.9 (0.5–5.6) mm. The postoperative volume of the fractured orbit was 1.34 ml less than that of the non-fractured side, but this was not clinically relevant. None of the patients required reoperation and none had any implant-related complications during follow up. We conclude that patient-specific implants are an adaptable and reliable treatment for primary orbital trauma, and that the Helsinki protocol may have wider applications in the treatment of facial fractures. © 2018 The British Association of Oral and Maxillofacial Surgeons