title: Lack of ossification after cranioplasty for craniosynostosis: a review of relevant factors in 592 consecutive patients.
abstract: The Center for Craniofacial Anomalies of Necker-Enfants-Malades Hospital presents a retrospective study of the outcome of 592 patients who were operated on for craniosynostosis between 1976 and 1991. The quality of ossification 1 year after operation is reported, with a focus on influencing factors. The lack of ossification rate was 5% (30 of 592). Three parameters are identified as increasing the risk of poor osseous wound healing: local postoperative infection; forehead advancement, especially when accomplished with resorbable osteosynthesis; and brachycephaly. In contrast, repaired tears of the dura mater do not seem to pose a risk. Seventy-five percent of patients with local infection and 12.4% with forehead advancement presented a lack of ossification, which is statistically significant (p < 0.001). Lack of ossification can compromise aesthetic and functional results. Decreasing postoperative infection and stable fixation may help promote ossification.
authors.affiliation: Center for Craniofacial Anomalies, Hopital Necker-Enfants-Malades, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Prevot
authors.forename: D
authors.initials: D
authors.lastname: Renier
authors.forename: D
authors.initials: D
authors.lastname: Marchac
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000601:surgery*; D004388:Dura Mater / Q000293:injuries; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010012:Osteogenesis; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection; D017211:Treatment Failure