title: The evolving role of springs in craniofacial surgery: the first 100 clinical cases.
abstract: BACKGROUND
  The use of springs in craniofacial surgery originated at Sahlgrenska University Hospital in 1997 as a way of remodeling the cranial vault postoperatively.
  
  
  METHODS
  The hospital records of the first 100 operations involving spring placement were analyzed retrospectively. Demographic, perioperative, and postoperative data were recorded.
  
  
  RESULTS
  Two hundred forty-six springs were used in 96 patients. Results for sagittal, metopic, bicoronal, multiple synostoses, and midface surgery are presented. In total, five patients (5 percent) required further surgery because of undercorrection. There were no major complications. Spring dislodgement (5 percent) was the most common complication in early cases. Raised intracranial pressure resulted in a protocol change with the use of compressive springs. The data compare favorably with those of standard craniofacial procedures performed in the same unit.
  
  
  CONCLUSIONS
  This therapeutic modality in craniofacial surgery has allowed minimization of the extent of surgery without compromising clinical outcomes. Springs have now become part of the authors' treatment protocol for craniosynostosis and midface surgery. The authors have shown the use of these techniques to be safe and, in selected situations, to offer significant advantages over other methods of treatment.
authors.affiliation: Göteborg, Sweden; Wellington, New Zealand; Winston-Salem, N.C.; and Perth, Western Australia, Australia From the Craniofacial Unit, Department of Plastic Surgery, Sahlgrenska University Hospital; Craniofacial Unit, Department of Plastic Surgery, Lower Hutt Hospital; Department of Plastic and Reconstructive Surgery, Wake Forest University Medical Center; and Craniofacial Unit, Department of Plastic Surgery, Princess Margaret Hospital.
authors.forename: Claes G K
authors.initials: CGK
authors.lastname: Lauritzen
authors.forename: Charles
authors.initials: C
authors.lastname: Davis
authors.forename: Anna
authors.initials: A
authors.lastname: Ivarsson
authors.forename: Claire
authors.initials: C
authors.lastname: Sanger
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Hewitt
mesh_terms: D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*; D013193:Stainless Steel; D013314:Stress, Mechanical; D016896:Treatment Outcome
chemical_list: D013193:Stainless Steel