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Orbital fracture in children has its own characteristics. Choosing the suitable plastic materials is the effective measurement to improve the successful rate of surgery. Absorbable plate filling provides a new material for children with orbital fracture. However, few studies compare the effectivity and safety between absorbable plate filling and conventional filling.
The aim of this study was to compare the long-term efficacy and safety between absorbable plate and Medpor implants in the repair of pediatric orbital fracture.
Clinical data of 72 eyes of 72 pediatric patients with orbital fracture who received surgicals reconstruction in Beijing Tongren Eye Center from 2008 April to 2014 August were respectively analyzed, including 28 patients with absorbable plates filling and 44 patients with Medpor implants. Demography and preoperative clinical signs were matched between the two groups. Operative procedure was same except the implanted materials. The functional training of extraocular muscle was performed since the second day after surgery in both groups. The imaging findings of the orbit were evaluated by computed tomography (CT) before and after surgery. The patients were followed-up for avarage 12.7 months after operation. The therapeutic effectiveness and safety were compared between the different implants, such as incidence of enophthalmos, extraocular movement impairment and diplopia, and the sensory deficit of skin and complications were documented.
Extraocular muscle movement improved and diplopia alleviated or disappeared in 92.9% (26/28) in the absorbable plate group and 90.9% (40/44) in the Medpor group, without significant difference between the two groups (P=0.57). The sensory deficit of skin was found in 13 eyes (46.4%) and 20 eyes (45.5%) in the absorbable plate group and Medpor group, respectively, and there was no significant difference between the two groups (P=0.56). CT revealed that the anatomical reconstruction of orbits could be achieved in all patients in both groups without the shifting of implants and extrusion. No enophthalmos and postoperative infection were found in absorbable plate group, however, the residual enophthalmos or late infection was found in 1 eye for each in the Medpor group.
Both the absorbable plate and Medpor implants show good results for reconstruction of pediatric orbital fracture. Absorbable plate is an ideal material for pediatric orbital blowout fracture because of fewer postoperative complications.