Pediatric orbital floor fractures are uncommon, especially in babies under the age of 2 years old. The conservative treatment is usually used except in inferior rectus entrapment, enopthalmous, and diplopia cases. Autogenous bone is an attractive option in a growing skeleton, but donor site immaturity presents a challenge for the surgeon. Although cranial grafts are a great option in adults, the lack of diploic space maturity separating the outer and inner tables might be discouraging. The use of prosthetic material might result in migration with growth and typically will require removal in a second surgery. Resorbable implants are attractive but can be expensive and might not be available in all trauma centers. In this research, we report a case of orbital floor fracture in an 18-month-old baby who presented with worsening enophthalmos repaired by calvarial graft using the piezosurgery and three-dimensional printed skull model after mirror imaging the non-affected side.
