Purpose: Nasoorbitoethmoid (NOE) fractures are complex and often challenging to repair. Inadequate treatment may result in secondary deformities which are difficult to treat. Severely comminuted fractures require repositioning of the medial canthal tendon. The purpose of this study was to evaluate all results in treating these challenging injuries. The work is to be used as a basis for continuing quality improvement of our surgical technique.
Patients and methods: [corrected] Ten consecutive patients who sustained a comminuted NOE (type III) fracture were included in this study. All patients had comminution of the central fragment involving the detachment of the medial canthus.
Results: Transnasal reduction, primary grafting, and plate and screw fixation were used for all patients. Two patients demonstrated slight asymmetry between the medial canthi. Two patients were observed to have overprojection in the nasofrontal region.
Conclusion: Severely comminuted type III NOE fractures are best treated primarily to avoid secondary deformities.