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Home / Equine Research Bank / Vet Surg / Reconstruction of an orbital fracture in a mare using a 3D-p...
Veterinary surgery : VS2025; doi: 10.1111/vsu.70050

Reconstruction of an orbital fracture in a mare using a 3D-printed patient-specific implant.

Abstract: To describe surgical repair of an orbital wall fracture communicating with the caudal maxillary sinus using a three dimensional (3D)-printed, patient-specific implant (PSI). Methods: Case report. Methods: A 25-year-old Haflinger mare (370 kg). Methods: The mare presented with severe chemosis and emphysema of the left upper and lower eyelid of 2-weeks duration due to a fracture of the ventral floor and inner wall of the left orbit that communicated with the caudal maxillary sinus. Computed tomographic (CT) data were used to design a PSI replicating the inner surface of the unfractured orbit. The data were converted to an STL file and 3D-printed using polylactic acid (PLA) filament. Surgical access was obtained via a concho-frontal sinus flap combined with sinoscopy. To reconstruct and seal the orbit, the PSI was lined with porcine small intestinal submucosa and secured to the inner orbital wall using two 3.0 mm titanium locking screws and synthetic, non-absorbable transosseous fiber loops. Results: The emphysema resolved postoperatively, and ocular function was unrestricted by the implant. Infection developed subcutaneously adjacent to the transosseous suture fixation at the maxillary bone but resolved with conservative management. Follow-up CT at 11 weeks and owner reports after 18 months confirmed a favorable cosmetic and functional outcome, with only minimal residual ptosis of the left upper eyelid. Conclusions: Application of a PSI axially to the left orbit successfully reconstructed the orbital wall and resolved the communication with the caudal maxillary sinus. Conclusions: Patient-specific implants represent a novel surgical option for the repair of complex orbital wall fractures in horses.
© 2025 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2025-10-30 PubMed ID: 41165049DOI: 10.1111/vsu.70050Google Scholar: Lookup
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APA
Gernhardt J, Böttcher P, Eule JC, Mählmann K, Müller E, Lischer CJ. (2025). Reconstruction of an orbital fracture in a mare using a 3D-printed patient-specific implant. Vet Surg. https://doi.org/10.1111/vsu.70050

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Gernhardt, Jennifer
  • Equine Clinic, Freie Universität Berlin, Berlin, Germany.
Böttcher, Peter
  • Small Animal Clinic, Freie Universität Berlin, Berlin, Germany.
Eule, J Corinna
  • Unit for Ophthalmology, Veterinary Hospital, Freie Universität Berlin, Berlin, Germany.
Mählmann, Kathrin
  • Equine Clinic, Freie Universität Berlin, Berlin, Germany.
Müller, Eva
  • Equine Clinic, Freie Universität Berlin, Berlin, Germany.
Lischer, Christoph J
  • Equine Clinic, Freie Universität Berlin, Berlin, Germany.

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