To study the efficacy of ETO sterilized X-ray film Vs various autologous grafts which were
placed as an overlay over titanium mesh implant in preventing the incidence of adherence
syndromes following blowout fracture repairs using titanium mesh implants

10 patients who had large blowout fractures of the floor of the orbit which
required placement of titanium mesh implants with screw fixation were chosen for the study. ETO
sterilized X-ray film was placed over the titanium mesh to prevent direct tissue contact of the
titanium mesh with the orbital tissues in 5 patients,rib graft was placed as an overlay in 3
patients,iliac crest bone and auricular cartilage graft was placed in 2 patients.

ETO sterilized X-ray film was found to be well tolerated,inert ,easy to use and highly cost/
time effective and successful in preventing adherence syndromes associated with the use of
titanium implants in blowout fracture repairs of the orbit. One patient had implant displacement
with the use of rib cartilage which required surgical removal and another developed orbital cellulitis
which required Fess drainage.

ETO sterilized X-ray film can be placed over the titanium implant which prevents the
occurrence of Adherence syndromes following the use of titanium mesh in treating blowout
fractures of the orbit. X-ray film is inert,easily available,cheap and bio compatible and can be used as
an overlay implant.Other autologous grafts offer no significant advantages and are associated with
significant donor site morbidity and implant related complications.