Microfixation of acute orbital fractures.

Microfixation techniques were used as an adjunct to the use of miniplates and screws in the acute treatment of fractures involving the orbit in 42 patients over a 2-year period. Miniplates were used in all fractures at the Le Fort I level and at the zygomatic-frontal suture in high-energy injuries. Microfixation was used to stabilize all other fractures of the zygomatic, nasoethmoid, and frontal areas. Problems with plate visibility and objectionable palpability through thin periorbital skin were eliminated. The use of microplates allowed more precise positioning of small fragments than possible with miniplates or interfragmentary wires. Fracture reduction remained clinically stable in the frontal and nasoethmoid areas. Microplates were inadequate to resist soft tissue deforming forces along the infraorbital rim and the zygomatic arch in high-energy injuries.