Multidirectional cranial distraction osteogenesis for the treatment of craniosynostosis.
BACKGROUND
Although many operative methods for the treatment of craniosynostosis exist, whether any difference in outcome could be associated with either the child's age at surgery or the extent of the operation remains to be elucidated. The authors have developed a method of distraction osteogenesis for craniosynostosis that uses a new multidirectional cranial distraction osteogenesis system.


METHODS
From 2003 to 2008, 26 selected patients with syndromic and nonsyndromic craniosynostosis were treated with this method. The ages of the patients ranged from 9 to 139 months (median, 27 months). The follow-up period ranged from 13 to 81 months (median, 49 months).


RESULTS
The postoperative course was uneventful in all cases. The mean blood transfusion was 20.9 ml/kg. The mean postoperative hospital stay was 12 days. Sixteen of 49 (32.7 percent) anchor pins used in the first eight patients loosened because of bone absorption during the consolidation period. After the authors altered the screw shape, loosening occurred in seven of 81 pins (8.6 percent) in the last 18 patients. Loosening occurred in 28 of 204 traction pins (13.7 percent) among all patients. The phase of activation ranged from 8 to 14 days (mean, 10.5 days) and the consolidation period ranged from 21 to 42 days (mean, 29 days).


CONCLUSIONS
Overall, distraction osteogenesis with the multidirectional cranial distraction osteogenesis method is safe and effective. The authors conclude that the multidirectional cranial distraction osteogenesis method constitutes an excellent alternative for all phenotypes of syndromic or nonsyndromic craniosynostosis.
Tochigi, Japan From the Department of Plastic Surgery, Jichi Medical University.
Yasushi
Y
Sugawara
Hirokazu
H
Uda
Shunji
S
Sarukawa
Ataru
A
Sunaga
D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*