Various applications of titanium mesh screen implant to orbital wall fractures

As the number of high velocity injuries increases, orbital wall fractures that involve other facial bone fractures, especially those showing multiple crushed fractures have become increasingly common. However, owing to its complex anatomic structure, our inability to visualize details and relatively thin orbital wall, corrective restorations and fixations are very difficult. Recently several reports have claimed good results using titanium implants to repair orbital fracture. Over a period of 36 months, Titanium mesh screen 1.0 (SYNTHES®) were applied to the repair of orbital fracture in various ways, taking 39 examples of orbital wall fracture patients requiring operating treatment. A titanium mesh screen 1.0 was used either as an onlay implant after it was shaped to fit the anatomical shape of the fracture portion, or as cover implant to fix bony pieces after repairing a severely crushed fracture on the orbital rim or maxillary wall segments. 1.3-mm micro-screws were used to fix the titanium mesh screen when needed. The titanium mesh screen 1.0 was rigid, yet malleable enough to get the desired shape. It could be folded and screwed easily, and was also easy for follow-up with fewer artifacts on the CT findings. Therefore, we could restore and fix much easier and faster even crushed tiny bony pieces without loss and achieve more accurate three-dimensional anatomical reconstruction of orbital wall fracture.