ENDOSCOPIC REDUCTION AND INTERNAL CYANOACRYLATE FIXATION OF THE ZYGOMA

Objective: The objective of this study was to explore the feasibility of utilizing n-butyl-2 cyanoacrylate, a polymeric adhesive, for fixati on of the zygoma after fracture displacement. Design: A human cadaveri c model was developed and used. Setting: All experimentation was perfo rmed in the anatomy laboratory at the University of Western Ontario, L ondon, Ontario. Methods: The stability of zygomatic fractures endoscop ically reduced and fixed with cyanoacrylate was compared to that of co ntralateral fractures treated by traditional closed reduction. The loa d to failure of each repaired fracture was established using a previou sly described linear-load applicator. Results: The technique was easil y performed on all specimens and is described. Our data show that a zy goma, reduced and fixed in this manner, tolerates an 18-fold greater l oad 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 failu re to 17.6 kg. Conclusions: Endoscopic reduction and cyanoacrylate fix ation of zygomatic fractures deserve investigation in the clinical set ting.