The reconstruction of combined orbital floor and medial wall fractures is challenging due to the surgical approach and implant stability. A 0.5 mm thickness rigidity custom made titanium alley implant was created by 3-dimensional printing with electron-beam additive manufacturing. The implant was designed to cover the entire surface of the inferomedial orbit based on the flipped the contralateral orbit images. Although the cost was expensive, the use of three-dimensional printed implants for extensive orbital wall fractures was useful for decreasing operative time, and can be accessed with a limited surgical approach with a precise fit.
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