Abstract
BACKGROUND: Naso-orbital-ethmoid (NOE) fractures represent complex midface injuries that challenge aesthetic and functional reconstruction. This study evaluates the efficacy of techniques restoring intercanthal distance following operative repair of NOE fractures. METHODS: A retrospective case series was conducted of adults undergoing NOE fracture repair between 2010 and 2022. CPT codes were used to identify patients, with inclusion based on radiographic confirmation of NOE fractures. Demographic data, fracture classification, operative techniques, and pre- and post-operative CT measurements of intercanthal distance were analyzed by fracture type and type of repair. RESULTS: 191 patients were identified, mostly male (80%), with Type I fractures being most common (66%). Intercanthal wiring was used in 14% of cases, most frequently for Type II and III fractures. Of the 100 patients with post-operative comparison imaging, the median intercanthal distance improved from 34 mm to 31 mm. Intercanthal wiring yielded greater median distance correction. All patients achieved restoration of intercanthal distance within normal limits regardless of repair technique. CONCLUSIONS: Operative repair of NOE fractures using either plating or intercanthal wiring effectively restores normal intercanthal distance. While intercanthal wiring remains valuable in severe fractures, it may not be universally necessary. Further study is needed to refine the role of these repair techniques.