title: Craniofacial skeletal fixation using biodegradable plates and cyanoacrylate glue.
abstract: This study examined the feasibility of fixation of craniofacial bone using Lactosorb biodegradable plates adhered to bone with butyl-2-cyanoacrylate adhesive (Histoacryl) in a pig. The stability and bone-healing characteristics of this rigid fixation method were studied and compared with standard rigid fixation using metal plates and screws on osteotomy sites in the frontal bones and infraorbital rims. Rectangular osteotomies (2.0 x 3.0 cm) were performed on the right and left sides of the frontal bone and wedge-shaped osteotomies (1.5 x 1.7 cm) were made on the left and right infraorbital rims in seven Yorkshire pigs. Metal plates were applied with screws to the osteotomies on one side, and the other side was fixed with a biodegradable plate and butyl-2-cyanoacrylate. The animals were sacrificed at 8 weeks, and both sides were compared biomechanically and histologically. Radiographic, biomechanical, and histologic analyses were performed to evaluate skeletal stability, contour, accurate positioning of bony fragments, bone healing, and maximum torque to failure of the repair sites. Clinical and radiographic observations demonstrated stability of the bone fragments without any evidence of displacement. According to Student's t test for paired data, no statistical difference was found in the maximum torque to failure of fragments fixed with biodegradable plates and glue compared with those fixed with metal plates and screws (p > 0.05), whether or not a gap existed at the osteosynthesis site. Although the sample size was small, no differences were noted between the two types of treatment groups. This study demonstrates that rigid internal fixation of osteotomized cranial bone fragments using biodegradable plates and butyl-2-cyanoacrylate is as effective as metal plate and screw fixation in this animal model.
authors.affiliation: Division of Plastic Surgery, Massachusetts General Hospital, Boston, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Ahn
authors.forename: C D
authors.initials: CD
authors.lastname: Sims
authors.forename: M A
authors.initials: MA
authors.lastname: Randolph
authors.forename: D
authors.initials: D
authors.lastname: O'Connor
authors.forename: P E
authors.initials: PE
authors.lastname: Butler
authors.forename: M T
authors.initials: MT
authors.lastname: Amarante
authors.forename: M J
authors.initials: MJ
authors.lastname: Yaremchuk
mesh_terms: D000818:Animals; D001673:Biodegradation, Environmental; D001696:Biomechanical Phenomena; D001860:Bone Plates; D004659:Enbucrilate; D005260:Female; D005624:Frontal Bone / Q000601:surgery*; D019344:Lactic Acid; D009915:Orbit / Q000601:surgery*; D010027:Osteotomy; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers; D013552:Swine; D014014:Tissue Adhesives; D014945:Wound Healing
chemical_list: D011108:Polymers; D014014:Tissue Adhesives; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D004659:Enbucrilate