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Distraction Osteogenesis for Unicoronal Craniosynostosis
- Source :
- Plastic and Reconstructive Surgery. 142:904e-908e
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background The limitations of the soft-tissue envelope, devascularized bone grafts, and relapse of the deformity are important considerations in the surgical treatment of unicoronal craniosynostosis. The authors report their technique evolution of distraction osteogenesis for treatment of patients with unicoronal craniosynostosis. Methods Open anterior cranial vault reconstruction combined with internal distraction was used, with the aid of virtual surgical planning. Technique evolution included maximizing bone flap perfusion by means of limited rotational flap osteotomies, and preservation of dural attachments. Clinical and procedural characteristics including distraction protocol, intracranial volume change, efficiency of distraction, transfusion, operative time, length of hospitalization, complications, and postoperative outcomes were analyzed. Results Sixteen patients with nonsyndromic unicoronal craniosynostosis underwent repair between August of 2013 and December of 2016. Mean age was 9.0 months. Distractors were advanced a mean of 27.1 mm and achieved a cranial volume change of 29.5 percent, with a mean efficiency of 1.3 percent increase per millimeter of distraction. Mean operating time was 169.3 minutes. Complications were predominately related to infections at the distractor site. At most recent follow-up, all patients had a Whitaker grade I result. Conclusions Distraction osteogenesis can be a safe and effective method of achieving satisfactory aesthetic outcomes and volume expansion for patients with unicoronal craniosynostosis. The technique presented is proposed to maximize bone flap viability and limit relapse of deformity. Further long-term follow-up is needed for definitive comparison with traditional anterior cranial vault reconstruction. Clinical question/level of evidence Therapeutic, IV.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Operative Time
Osteogenesis, Distraction
Craniosynostoses
Surgical planning
Surgical Flaps
03 medical and health sciences
0302 clinical medicine
Distraction
medicine
Deformity
Humans
Retrospective Studies
Bone Transplantation
business.industry
Infant
Retrospective cohort study
Surgery
Treatment Outcome
Frontal bone
030220 oncology & carcinogenesis
Frontal Bone
Distraction osteogenesis
Female
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 00321052
- Volume :
- 142
- Database :
- OpenAIRE
- Journal :
- Plastic and Reconstructive Surgery
- Accession number :
- edsair.doi.dedup.....dadf465b0eb746fb480759ddc934936f