title: Multi-directional Le Fort III midfacial distraction using an individual prefabricated device.
abstract: BACKGROUND
  Midfacial distraction following Le Fort III osteotomy has become an established procedure for midfacial advancement of syndromic craniosynostosis patients. A frequent difficulty is the precise three dimensional (3D) alignment of the distracted midface and the proper fixation of the distraction device in the midfacial area. In this study we present an individual modification method for commercial distraction devices comprising the establishment of prefabricated fixation plates and parallel connecting pins.
  
  
  METHODS
  Individual prefabricated fixation plates for the zygomatic buttress were combined with two commercial distraction devices.
  
  
  METHODS
  The fixation plates were made by a casting technique using individual cranial models as templates. The latter were fabricated by the rapid prototyping technique of 3D powder printing. For precise realization of the distraction vector, two commercial devices were combined and attached rigidly to the fixation plates by two parallel pins.
  
  
  RESULTS
  In the clinical routine, the 3D powder printing technique enables the simple fabrication of precise individual cranial models, which are required for manufacturing individual fixation plates. The combination of two commercial distraction devices facilitates the appropriate transfer of complex distraction vectors into the midfacial area.
  
  
  CONCLUSIONS
  The technique presented should be useful for a precise multi-directional midfacial distraction following Le Fort III osteotomy.
authors.affiliation: Department of Cranio-Maxillo-Facial Surgery, University of Würzburg, Würzburg, Germany. klammert_u@klinik.uni-wuerzburg.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Klammert
authors.forename: Hartmut
authors.initials: H
authors.lastname: Böhm
authors.forename: Tilmann
authors.initials: T
authors.lastname: Schweitzer
authors.forename: Kristian
authors.initials: K
authors.lastname: Würzler
authors.forename: Uwe
authors.initials: U
authors.lastname: Gbureck
authors.forename: Jürgen
authors.initials: J
authors.lastname: Reuther
authors.forename: Alexander
authors.initials: A
authors.lastname: Kübler
mesh_terms: D000168:Acrocephalosyndactylia / Q000601:surgery; D000293:Adolescent; D001858:Bone Nails; D001860:Bone Plates; D002648:Child; D017076:Computer-Aided Design; D003394:Craniofacial Dysostosis / Q000601:surgery; D003398:Craniosynostoses / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D008953:Models, Anatomic; D009915:Orbit / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D019340:Osteotomy, Le Fort / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed; D055815:Young Adult; D015050:Zygoma / Q000601:surgery