Orbital floor fracture repair with placement of Supremid implant
This is Richard Allen at the University of Iowa. This video demonstrated repair of a left orbital floor fracture. Forced ductions are checked which are positive. A lateral canthotomy and inferior cantholysis are performed followed by a transconjunctival incision with the monopoloar cautery. Dissection is then carried out between the orbicularis muscle and the orbital septum to the inferior orbital rim. The periosteum is then incised and the elevated from the orbital floor where the entrapped tissue is elevated from the fracture. Forced ductions are again checked which are free. A supramid implant is used to cover the fracture. The implant is fixated to the inferior orbital rim with one or two titanium screws. The transconjunctival incision is then closed with interrupted 7-0 vicryl suture. The cantholysis is repaired by performing a lateral tarsal strip procedure which fixates the lateral canthal tendon to the lateral orbital rim at the level of Whitnalls tubercle. The canthotomy incision can then be closed with your skin suture of choice.