title: Distraction vs remodeling surgery for craniosynostosis.
abstract: OBJECTIVE
  We designed several distraction devices and applied these instruments in 14 patients with varying types of craniosynostosis. The aim of this report is to clarify the advantages and disadvantages of these surgical methods and to discuss current concepts for the surgical strategy in the treatment of craniosynostosis.
  
  
  METHODS
  From January 2000 to July 2005, 28 patients with craniosynostosis were retrospectively analyzed. Surgical treatment was performed on 14 patients using the distraction method with internal distraction devices that we designed, in which 5 patients had plagiocephaly, 3 brachycephaly, and 6 scaphocephaly. All patients underwent preoperative and postoperative evaluations, which included the patient's neurological state, and three-dimensional CT.
  
  
  RESULTS
  With distraction devices, the time required for the surgery could be shortened almost 3 1/3 h; the bleeding during the surgery was decreased with reduced requirement of more than 200 ml of blood transfusion as compared with remodeling surgery. Postoperatively achieved distraction distances varied from 30.0 to 47.5 mm (mean, 42.99 mm). The average increased volume percent of cranium in distraction surgery group was 20.9% (range, -11.5 to 58.9%) after full distraction.
  
  
  CONCLUSIONS
  With distraction surgery, satisfactory cranial volume expansion and aesthetically pleasing morphological states were achieved in all cases, and the efficacy was statistically significantly high as compared with remodeling method.
authors.affiliation: Institute for Surgical Research, Ludwig Maximilian University, Munich, Germany.
authors.forename: Seong-Woong
authors.initials: SW
authors.lastname: Kim
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Shim
authors.forename: Nick
authors.initials: N
authors.lastname: Plesnila
authors.forename: Yong-Oock
authors.initials: YO
authors.lastname: Kim
authors.forename: Joong-Uhn
authors.initials: JU
authors.lastname: Choi
authors.forename: Dong-Seok
authors.initials: DS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003398:Craniosynostoses / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000379:methods*; D017063:Outcome Assessment, Health Care; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies