Contemporary Surgical Approaches in the Management of Orbital Fractures

AbstractOrbital fractures are among the most common maxillofacial injuries and frequently result from road traffic accidents, interpersonal violence, sports injuries, and accidental falls. Due to the complex anatomy of the orbit and its close association with vital ocular and neurovascular structures, management of these fractures remains surgically challenging. The orbital floor and medial wall are particularly vulnerable to trauma, often leading to complications such as diplopia, enophthalmos, restricted ocular movements, infraorbital nerve paresthesia, and facial asymmetry. Computed tomography plays a crucial role in diagnosis, assessment of fracture mextent, and surgical planning. Surgical intervention is generally indicated in cases of persistent diplopia, extraocular muscle entrapment, significant enophthalmos, or large orbital wall defects.Various surgical approaches have been described for orbital fracture repair, including subciliary, subtarsal, transconjunctival, transcaruncular, and endoscopic techniques. Traditional transcutaneous approaches provide excellent exposure but may result in visible scarring and eyelid complications, whereas transconjunctival and transcaruncular approaches offer superior cosmetic outcomes with fewer postoperative complications. Endoscopic approaches represent a minimally invasive alternative with improved visualization but require advanced surgical expertise. Contemporary management emphasizes individualized treatment planning, minimally invasive techniques, multidisciplinary collaboration, and appropriate reconstruction materials to achieve optimal functional and aesthetic outcomes.