Finite element analysis of the human orbit. Behavior of titanium mesh for orbital floor reconstruction in case of trauma recurrence

Abstract : Introduction The authors’ main purpose was to simulate the behavior of a titanium mesh implant (TMI) used to reconstruct the orbital floor under the stress of a blunt trauma. Materials and methods The orbital floor of a previously validated finite element model (FEM) of the human orbit was numerically fractured and reconstructed by a simplified TMI. Data from a CT scan of the head were computed with MICMICS (Materialise, Louvain, Belgium) software to re-create the skull's geometry. The meshing production, the model's properties management and the simulations of blunt traumas of the orbit were conducted on HYPERWORKS® software (Altair Engineering, Detroit, MI, USA). Some of the elements of the orbital floor were selected and removed to model the fracture; these elements were duplicated, their characteristics being changed by those of titanium to create a TMI covering this fracture. A 3D FEM composed of 640,000 elements was used to perform 21 blunt trauma simulations on the reconstructed orbit. Results In 90.4% (19/21) of the tests conducted, the TMI, whether free from any bony attachment or screwed to the orbital rim, has tended to move in the orbit and/or to deform. Discussion In the event of traumatic recurrence, which is not rare, TMIs may deform in a “blow-in” motion and threaten intra-orbital structures.