Fundamentals of Orbital Fractures

Orbital fractures are common injuries. They may involve only this area or be associated with different types of midface fractures (zygomatic complex, naso-orbito-ethmoid, Le Fort type, or panfacial). Diagnosis is based on a careful physical examination and a thin-sliced CT scan. These should be cautiously performed in case if there are associated orbital compartmental syndromes, which may even lead to amaurosis if cranial nerves are involved. A preoperative ophthalmologic examination is essential, as well as subsequent control follow-ups. Surgical treatment should be based on a clear diagnosis, and it may be performed through local approaches or even the coronal approach. Several quality control measures can be used in the pre-, intra- and postoperative periods (preoperative planning in the acute and sequelae phases; pre-, intra- and postoperative CT scans; and pre-formed or customized implants). If these guidelines are followed, orbital reconstruction will be more reliable.