Reconstruction of a Complicated Orbital Depression Fracture with Medial Wall and Globe Repositioning in a Horse: A Collaboration Across Disciplines and Specialties.

The research presents a unique case of successful surgical reconstruction of a complicated orbital depression fracture in a horse, demonstrating that severe orbital fractures in horses involving displacement of the globe can be effectively corrected via a multidisciplinary approach.

Research Summary

• The research revolves around the clinical case of a 6-year-old Irish Sport Horse gelding that suffered a severe orbital trauma and globe displacement due to an accident.
• Initial surgical procedures were conducted to elevate the depression fractures of the facial bones and reconstruct the orbit.
• Despite these efforts, the globe of the eye was found recessed due to displacement of the medial wall and floor of the orbit within the conchofrontal sinus.

Pre-Surgical Planning

• A three-dimensional model of the fracture configuration was generated to assist in pre-surgical planning of globe repositioning.

Surgical Approach

• In a subsequent surgical procedure, a resorbable plate was placed in the floor of the orbit and the medial orbital wall.
• The globe was repositioned using a sinoscopic approach and then stabilized with tissue expanders within the conchofrontal sinus.
• The tissue expanders within the sinus were removed some three weeks later post-surgery under standing sedation.

Postoperative Results

• Following the surgical interventions, the right globe was successfully repositioned in a more correct anatomical orientation.
• The horse resumed work three months after the surgery and competed at its original level five months postoperatively.
• No visual deficits were reported by the owners post-surgery, demonstrating a successful intervention.

Conclusions

• The researchers concluded that comprehensive efforts to restore the medial wall and/or floor of the orbit in tandem with globe repositioning should be considered for horses with severe orbital depression fractures.
• This approach leads to the correction of abnormal globe position, offering prospects for enhanced recovery and functional restoration.