THERE has been an interesting evolution in the management of facial fractures. The ever increasing number of automobile accidents have provided the impetus for the development of simpler and more effective methods of treatment.
The latest trend is toward the direct surgical approach in the treatment of facial fractures. We believe that this method of management produces better anatomical and functional results and obviates later complications so difficult to treat.
It is the purpose of this report to outline the management of severe fractures involving the orbital floor and to stress the advantages of the direct approach using prosthetic implants where necessary. Our anesthetic management will also be described since it simplifies the handling of these injuries.
In 1928, in a report on fractures about the orbit, Gill mentioned the use of a silver wire suture in order to maintain fragments in old depressed fractures following reduction by refracturing.1
Saul Hoffman, Daniel L. Weiner, Arthur J. Barsky. Direct Approach in Management of Severe Facial Fractures Involving Orbital Floor. Arch Surg. 1967;94(3):403–412. doi:10.1001/archsurg.1967.01330090097024