title: Le Fort III rigid external distraction complicated by intracranial movement of halo fixation pins.
abstract: Midface hypoplasia in a 5-year-old boy with Crouzon syndrome was treated using a rigid external distraction device. Seven months prior to this surgery, a bone allograft was used during frontal-orbital bar advancement. Three weeks after the Le Fort III distraction a depression fracture was diagnosed, associated with an intracerebral screw penetration of 3.5 cm. This case report cautions against the use of distraction osteogenesis in patients when previous allografts were used for calvarial reconstruction. We suggest that a preoperative computed tomography scan is mandatory to accurately delineate the location for placement of the pins.
authors.affiliation: Division of Pediatric Plastic Surgery, Wilhelmina Children's Hospital, University of Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands. c.c.breugem@umcutrecht.nl
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
authors.forename: Kevin
authors.initials: K
authors.lastname: Bush
authors.forename: Donald F
authors.initials: DF
authors.lastname: Fitzpatrick
mesh_terms: D001858:Bone Nails / Q000009:adverse effects*; D016025:Bone Transplantation / Q000295:instrumentation*; D002675:Child, Preschool; D003394:Craniofacial Dysostosis / Q000601:surgery*; D003399:Craniotomy; D005548:Foreign-Body Migration; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D019340:Osteotomy, Le Fort / Q000379:methods*; D012887:Skull Fractures / Q000601:surgery