Abstract：
To compare the reconstruction of orbital fractures using patient-specific implants (PSI) and conventional pre-formed titanium mesh; to develop a method of three-dimensional (3D) superimposition and analysis of the reconstructed orbits; and to present the pitfalls in 3D planning of orbital PSI and how to avoid them. This was a retrospective study of patients with orbital fractures who were treated in our institution between the years 2022 and 2023 using PSI or conservative prefabricated titanium mesh. Three different methods for virtual reconstruction of orbital fractures were used and are detailed with advantages, disadvantages and indications. Data acquired included age, gender, method of reconstruction, functional outcomes and aesthetic outcomes. 3D analysis for accuracy of reconstruction was performed. A total of 23 patients were included; 12 were treated using PSI and 11 using prefabricated titanium meshes. There were 8 male and 4 female patients in the PSI group comparted to 5 and 6 in the prefabricated group. All three virtual methods for reconstruction were used successfully, each with the proper indications. When comparing PSI reconstruction to conventional mesh, a significant difference in accuracy was observed; PSI cases showed an inaccuracy of 0.58 mm compared to 1.54 mm with the conventional method. Complications are presented, and tips for avoiding them are detailed. Three different methods for virtual reconstruction were used successfully; automated computerized reconstruction is used for small defects, repositioning is the superior method for non-comminuted cases while mirroring is the method of choice in comminuted fractures. 3D analysis can be performed using a novel method detailed in this report. PSI reconstruction showed superior results, indicating it should be the method of choice when possible. Pitfalls are presented and approaches to prevent them are discussed. Orbital reconstruction is a very important entity in maxillofacial surgery with crucial functional and esthetical implications, and one should use virtual planning and PSI implants, as they significantly improve outcomes.
摘要：
比较使用患者特定植入物（PSI）和常规预成型钛网重建眼眶骨折；开发一种三维（3D）叠加和分析重建眼眶的方法；并介绍眼眶PSI3D规划中的陷阱以及如何避免它们。这是一项对眼眶骨折患者的回顾性研究，这些患者在2022年至2023年期间在我们机构使用PSI或保守的预制钛网进行治疗。使用了三种不同的方法对眼眶骨折进行虚拟重建，并具有优势。缺点和适应症。获得的数据包括年龄，性别,重建方法,功能结果和美学结果。进行了重建准确性的3D分析。总共包括23例患者；12例使用PSI治疗，11例使用预制钛网治疗。PSI组中有8名男性和4名女性患者，而预制组中有5名和6名。所有三种虚拟重建方法都成功使用，每个都有适当的适应症。当将PSI重建与常规网格进行比较时，观察到准确性存在显着差异;PSI病例显示出0.58mm的不准确性，而常规方法为1.54mm。出现并发症，和避免它们的技巧是详细的。成功使用了三种不同的虚拟重建方法；自动化的计算机重建用于小缺陷，对于非粉碎性骨折，重新定位是较好的方法，而镜像是粉碎性骨折的首选方法。可以使用本报告中详述的新方法进行3D分析。PSI重建显示出优越的后果，表明它应该是可能的选择方法。提出了陷阱，并讨论了防止陷阱的方法。轨道重建是颌面外科中非常重要的实体，具有至关重要的功能和美学意义，应该使用虚拟规划和PSI植入，因为它们显著改善了结果。
