Primary reconstruction of orbital fractures using patient-specific titanium milled implants: the Helsinki protocol

Br J Oral Maxillofac Surg. 2018 Nov;56(9):791-796. doi: 10.1016/j.bjoms.2018.08.008. Epub 2018 Sep 13.


Preoperative virtual planning and the use of patient-specific implants enable exact reconstruction of orbital fractures. We present our results and experience of reconstruction of isolated orbital fractures with patient-specific implants, according to the Helsinki protocol, in 15 patients who were followed up for at least three months postoperatively. The mean (range) difference between the positions of virtually planned, and postoperative, implants was 1.9 (0.5-5.6) mm. The postoperative volume of the fractured orbit was 1.34ml less than that of the non-fractured side, but this was not clinically relevant. None of the patients required reoperation and none had any implant-related complications during follow up. We conclude that patient-specific implants are an adaptable and reliable treatment for primary orbital trauma, and that the Helsinki protocol may have wider applications in the treatment of facial fractures.

Keywords: facial fracture; orbital fracture; patient specific implant; virtual planning.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fracture Fixation, Internal / instrumentation*
  • Humans
  • Male
  • Middle Aged
  • Orbital Fractures / diagnostic imaging
  • Orbital Fractures / surgery*
  • Orbital Implants*
  • Prosthesis Design*
  • Retrospective Studies
  • Titanium*
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Titanium