Inferior rectus muscle entrapped by Teflon implant after orbital floor fracture repair.

A patient with a tripod fracture had entrapment of the inferior rectus muscle after reconstruction of an orbital floor defect with an alloplastic implant. Prior to insertion of the implant, the operating surgeon reported no motility disturbance. An orbital computed tomography scan suggested that the implant impinged on the inferior rectus muscle. Because of persistent diplopia, the orbit was reexplored. An intraoperative forced duction test prior to removal of the implant was positive in the field of action of the inferior rectus muscle. An intraoperative forced duction test after removal of the implant was negative in the field of action of the inferior rectus muscle. Motility was markedly improved after removal of the implant. These findings confirm that the implant was the cause of the entrapment. The surgical technique utilized to minimize complications after orbital floor reconstruction with the implant is outlined in this article.