Comparison of 'sutureless' Transconjunctival and Subciliary Approach for Treatment of Infraorbital Rim Fractures: a Clinical Study.

Purpose: The aim of the study is to compare subciliary incision and 'sutureless' transconjunctival incision in the treatment of infraorbital rim fractures.

Materials And Method: In this prospective study, 40 patients with fractures of the infraorbital rim were selected and divided into 2 groups using random sampling technique. Group A patients were treated using 'sutureless' transconjunctival technique and group B patients were treated using subciliary approach. The following parameters were compared a) time taken, intraoperative ease of access, exposure achieved; b) clinical outcome and postoperative complications; c) Aesthetic outcome at intervals of 15 days, 1 month and 3 months.

Results: Total time taken for completion of surgery was lesser in group A patients. The presence of subconjunctival ecchymosis (at 1 month interval) and neurological deficit was found to be statistically significant (<0.05) in the 'subciliary' group of patients. The transconjunctival approach showed better esthetic results and fewer post-operative complications.

Conclusion: The subciliary approach gives good exposure of the infra-orbital rim and is better suited to reduce extensively displaced fractures of the infra-orbital rim. The transconjunctival approach is comparatively faster, gives better esthetic results and fewer post-operative complications but is technique sensitive and requires an additional lateral canthotomy in cases where more exposure is needed.