Injury to the orbital plate of the frontal bone.

Twelve cases of fracture of the orbital plate of the frontal bone are reviewed to clarify this important clinical problem and to suggest satisfactory methods of management. Common signs and symptoms include forehead laceration and deformity, and fracture of the frontal sinus. Loss of vision can occur, and in the seeing eye, diplopia can develop in several fields of gaze. Downward or upward projection of the orbital plate of the frontal bone can cause exophthalmos or enophthalmos. Cerebrospinal fluid leak, with or without meningitis, and seizures can also be part of the syndrome. Effective treatment consists of repairing or obliterating the frontal sinus, reducing the orbital root fracture, and repositioning the globe. Rib or iliac crest grafts, acrylic implants, and temporalis muscle-galea flaps are useful in correcting the deformity and restoring appropriate function. Long-term follow-up examinations are an important part of patient care.