Mantle design: a composite construct for orbital floor reconstruction.

We present a unique case of orbital floor and wall reconstruction after complete destruction by a self-inflicted gunshot wound. The complex comminuted fracture was repaired using a composite construct design (the mantle design) that was fixed in place using mini plates and screws. The designed composite graft was shaped exactly to fit the area of the orbital floor and maxilla to create stability and support for the globe.The orbital floor and maxilla were repaired using this special design, which was created based on the basic physical principles of mantle constructs that have been known for many years to be strong, durable, and stable. After surgery, radiologic evaluation revealed excellent placement of our construct. This particular reconstruction method may be used in patients with severe orbital bony destruction with no surrounding stable bony support elements, which are required to reconstruct the orbital floor in patients with trauma using either an autologous or a biologic implant.