Surgical repair of medial wall fractures.

We treated ten patients with medial wall fractures, five of whom had concomitant floor fractures. The most consistent preoperative findings were restriction in abduction with retraction of the globe and limitation in adduction. A direct medial canthal surgical approach provided adequate exposure for removing incarcerated tissue as well as covering the defect with a thin silicone implant. There were no surgical complications or evidence of implant migration, the longest follow-up being two years. Of the ten patients, six had satisfactory results with full or nearly full ductions, one was orthophoric in the primary position but still had significant restriction in abduction, and three had persistent diplopia in the primary position.