Ramal bone graft for management of infra-orbital rim fractures with defects – Technical note and a series of 16 cases

The purpose is to describe a technique of using ramal bone graft for reconstructing defects of the infra-orbital rim (IOR), assess outcomes and complications. This was a retrospective chart review of 16 patients who underwent ramal bone grafting for IOR fractures. Outcomes evaluated were improvement in clinical findings (lid/globe malposition, tethering of facial skin and implant extrusion) and complications. Data analysis included descriptive statistics. The sample included 15 males and 1 female, with a mean age of 31.6 years. Lid malposition, globe malposition and tethering of facial skin was seen in 16, 13 and 6 patients, respectively. One patient demonstrated extrusion of implant. The mean size of bone harvested was 14 × 7 mm. All patients demonstrated improved globe position post-treatment, while 3 had residual lid retraction. Two patients demonstrated wound dehiscence in the donor site. In conclusion ramal bone graft was found to be a viable alternative for IOR reconstruction.