21406 Open treatment of fracture of orbit, except blowout; without implant

Name of the Procedure:

Open treatment of fracture of orbit, except blowout; without implant

Summary

This procedure involves surgically repairing a fracture in the orbital bones (the bones around your eye) that was caused by trauma. Unlike the "blowout" type of fracture, this surgery does not involve the placement of an implant.

Purpose

The purpose of this procedure is to treat broken bones in the orbital region following trauma. The goals are to realign the fractured bones, restore the normal structure of the orbit, and ensure proper function of the eye.

Indications

• Significant trauma leading to orbital fractures.
• Symptoms such as double vision, restricted eye movement, facial deformity, or severe swelling.
• Conditions where non-surgical management is ineffective.

Preparation

• Follow the specific fasting instructions provided by your surgeon, usually starting midnight before the procedure.
• Discuss your current medications with your doctor, who may advise you to adjust or pause certain drugs.
• Complete any required diagnostic tests, such as CT scans, to evaluate the extent of the fracture.

Procedure Description

1. You will be administered general anesthesia to ensure you remain unconscious and pain-free during the surgery.
2. The surgeon makes an incision, usually around the eye area, to access the fractured orbital bones.
3. The bones are meticulously realigned and stabilized using specialized surgical instruments.
4. Once the bones are correctly positioned, the incision is sutured closed.
5. No implants are used in this procedure; bone fragments are fixed in place naturally.

Duration

The procedure typically takes between 1 to 3 hours, depending on the severity of the fracture.

Setting

This surgery is performed in a hospital operating room or a specialized surgical center.

Personnel

• Ophthalmic or facial plastic surgeon
• Surgical assistants
• Anesthesiologist
• Operating room nurses

Risks and Complications

• Infection
• Bleeding
• Scarring
• Vision changes or double vision
• Complications from anesthesia
• Delayed healing or non-union of the fracture

Benefits

• Alleviation of symptoms like double vision and restricted eye movement.
• Restoration of normal eye function.
• Correction of facial deformities caused by the fracture.
• Immediate and significant improvement post-surgery, though complete healing may take several weeks.

Recovery

• Follow post-operative care instructions carefully, including taking prescribed medications.
• Expect swelling and bruising around the eye, which should subside within a few weeks.
• Avoid strenuous activities and heavy lifting until your surgeon approves.
• Attend all follow-up appointments to monitor healing progress.

Alternatives

• Non-surgical treatment, which may include observation, ice applications, and pain management medications.
• Closed reduction techniques, though these might not be effective in severe fracture cases.
• Pros of surgery include quicker and more reliable recovery; cons may involve surgical risks and recovery time.

Patient Experience

• During the surgery, you will be under general anesthesia and will not feel any pain.
• Post-surgery, pain will be managed with prescribed medications.
• You may experience swelling, bruising, and discomfort, which will gradually improve.
• Full healing and recovery can take several weeks, with adjustments to daily activities during this period.