Post traumatic Medial Canthal Tendon, MCT, rupture with telecanthus lead to aesthetic and functional impairment. The aim of the surgery is to restore anatomical structure of the medial canthal area to its natural and aesthetic form with preservation of function, for reinsertion or repositioning the medial canthal tendon that has been avulsed or displaced Tessier et al (1966) suggested trans-nasal canthopexy technique. It is a comparative clinical study to evaluate the trans-nasal medial canthopexy and mini plate and screws medial canthopexy that we suggest to reinsert the detached medial canthal tendon to its original bony attachment. Twenty war injured patients with unilateral telecanthus due to injured MCT attended to Al-Wasity hospital for reconstructive surgery and Emergency Hospital for Burn and Plastic Surgery Sulamaniyah, Iraq, in the period from April 2003 and March 2012, divided to two groups, (10) cases for each group, reconstruction of the lesion using two different surgical techniques, trans-nasal canthopexy for group one and mini plate and screws canthopexy for group two. Patients were followed up for up to 2 years postoperatively. Functional and aesthetic improvement had been achieved with minimal complication noticed with mini plate and screws canthopexy; the surgical time, in average, was 45 minutes in group two, wire stripping was recorded with two patients in group one. Mini plate and screws canthopexy is a short surgical procedure provides precise alignment of the medial canthal tendon and provides better post-operative symmetrical appearance and better aesthetic and functional result can be gained.
 

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