P J Cheski1, T W Matthews. 1. Department of Otolaryngology, University of Western Ontario, London.
Abstract
OBJECTIVE: The objective of this study was to explore the feasibility of utilizing n-butyl-2 cyanoacrylate, a polymeric adhesive, for fixation of the zygoma after fracture displacement. DESIGN: A human cadaveric model was developed and used. SETTING: All experimentation was performed in the anatomy laboratory at the University of Western Ontario, London, Ontario. METHODS: The stability of zygomatic fractures endoscopically reduced and fixed with cyanoacrylate was compared to that of contralateral fractures treated by traditional closed reduction. The load to failure of each repaired fracture was established using a previously described linear-load applicator. MAIN OUTCOME MEASURES: The primary outcome measure was load to failure (kg). RESULTS: The technique was easily performed on all specimens and is described. Our data show that a zygoma, reduced and fixed in this manner, tolerates an 18-fold greater load to failure than does a zygoma treated by closed reduction alone. Traditional closed reduction of complete fracture dislocations at all three zygomatic suture lines tolerates a mean load to failure of 0.95 kg. The use of cyanoacrylate fixation increases the mean load to failure to 17.6 kg. CONCLUSIONS: Endoscopic reduction and cyanoacrylate fixation of zygomatic fractures deserve investigation in the clinical setting.
OBJECTIVE: The objective of this study was to explore the feasibility of utilizing n-butyl-2 cyanoacrylate, a polymeric adhesive, for fixation of the zygoma after fracture displacement. DESIGN: A human cadaveric model was developed and used. SETTING: All experimentation was performed in the anatomy laboratory at the University of Western Ontario, London, Ontario. METHODS: The stability of zygomatic fractures endoscopically reduced and fixed with cyanoacrylate was compared to that of contralateral fractures treated by traditional closed reduction. The load to failure of each repaired fracture was established using a previously described linear-load applicator. MAIN OUTCOME MEASURES: The primary outcome measure was load to failure (kg). RESULTS: The technique was easily performed on all specimens and is described. Our data show that a zygoma, reduced and fixed in this manner, tolerates an 18-fold greater load to failure than does a zygoma treated by closed reduction alone. Traditional closed reduction of complete fracture dislocations at all three zygomatic suture lines tolerates a mean load to failure of 0.95 kg. The use of cyanoacrylate fixation increases the mean load to failure to 17.6 kg. CONCLUSIONS: Endoscopic reduction and cyanoacrylate fixation of zygomatic fractures deserve investigation in the clinical setting.