Bioresorbable fixation for congenital pediatric craniofacial surgery: a 2-year follow-up.
We describe our experience with the use of a polymeric biodegradable system for the correction of congenital pediatric craniofacial malformations. These fixation methods present several advantages over conventional metallic fixation systems. Our series consists of 51 patients that underwent craniofacial surgery, 46 for craniosynostosis, and 5 for encephalocele. The mean age of the patients was 3 years (median age 9 months). Patients with coronal or metopic craniosynostosis underwent a bifrontal craniotomy and anterior cranial vault and orbital reconstruction. Three patients with late sagittal synostosis underwent cranial vault reconstruction in two stages. Encephalocele defects were repaired with osteotomies, and/or onlay bone graft. Lactosorb (Lorenz Biomet, Warsaw, Ind.) plates (cut from a prefabricated mesh) and screws were employed using established fixation techniques. Cranial bone was the source of all bone graft when required. Pre- and postoperative clinical, radiographic and photographic examinations were performed on all patients. At 2 years follow-up, no evidence of infection, erythema, extrusion, instability of the bony fragments or relapse has been noted. The plates themselves were universally impalpable by the one year follow-up examination. The results in this series support the use of resorbable fixation systems in the correction of congenital craniofacial deformities.
Kurpad
S N
SN
Division of Pediatric Neurosurgery and Plastic Surgery and Craniofacial Center, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA. snkurpad@yahoo.com
Goldstein
J A
JA
Cohen
A R
AR
D020341:Absorbable Implants / Q000009:adverse effects; D001860:Bone Plates / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy; D004677:Encephalocele / Q000601:surgery; D005147:Facial Bones / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009915:Orbit / Q000601:surgery