title: Frontal cranial modeling using endocranial resorbable plate fixation in 27 consecutive plagiocephaly and trigonocephaly patients.
abstract: BACKGROUND
  Premature ossification of coronal and metopic sutures is treated by fronto-orbital remodeling. Such operations require stable fixation of the reshaped cranial bones. Currently, biodegradable plating systems are used to provide sufficient stability over the time that takes for the osteotomies to ossify. Plates that are placed traditionally on the outer surface of the cranium are often palpable and even visible through the thin overlying skin, compromising the cosmetic results of these operations. Improved aesthetics could be achieved by placing the plates endocranially.
  
  
  OBJECTIVE
  This study aimed to evaluate endocranial resorbable plate fixation and its clinical and radiographic results in frontal remodeling cranioplasty for plagiocephaly and trigonocephaly patients with follow-up sufficiently long for the plates to have been completely resorbed.
  
  
  METHODS
  A poly(lactide-co-glycolide) (PLGA) resorbable plating system was used on the inner aspect of frontal bone in 27 patients treated for coronal and metopic craniosynostoses. The outcome was evaluated at follow-up visits. The mean follow-up was 79.2 months.
  
  
  RESULTS
  Three patients had complications that required reoperations. None of these complications were related to the endocranial location of the plates. There were no problems with ossification of the osteotomy sites. All but one patient's outcome was judged as good or excellent.
  
  
  CONCLUSIONS
  Placement of resorbable fixation on the endocranial surface of the calvarial bones is safe, stable, and results in satisfactory aesthetics without interfering with the ossification of the cranial bones.
authors.affiliation: PEDEGO Research Center and Medical Research Center Oulu, University of Oulu, Oulu, Finland, niina@salokorpi.org.
authors.forename: Niina
authors.initials: N
authors.lastname: Salokorpi
authors.forename: Juha-Jaakko
authors.initials: JJ
authors.lastname: Sinikumpu
authors.forename: Tarja
authors.initials: T
authors.lastname: Iber
authors.forename: Heleia Nestal
authors.initials: HN
authors.lastname: Zibo
authors.forename: Tarmo
authors.initials: T
authors.lastname: Areda
authors.forename: Leena
authors.initials: L
authors.lastname: Ylikontiola
authors.forename: George K
authors.initials: GK
authors.lastname: Sándor
authors.forename: Willy
authors.initials: W
authors.lastname: Serlo
mesh_terms: D020341:Absorbable Implants; D001860:Bone Plates; D002675:Child, Preschool; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D059041:Plagiocephaly / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome