title: The usage of the three-dimension distractor in the NAVID system for plagiocephaly-three case reports.
abstract: BACKGROUND
  Distraction osteogenesis is a standard method for craniosynostosis. However, the technique using conventional devices still has some disadvantages, especially for anterior or posterior plagiocephaly with complex deformities. In the Nakajima's angle-variable internal distraction (NAVID) system originally for maxillary surgeries, the cranial three-dimension (D) distractor with three dimensionally movable joint at the anterior arm has been developed recently in order to prevent the interference in the distraction process and excessive force.
  
  
  METHODS
  In this paper, we first reported two cases of anterior plagiocephaly, and one case of posterior plagiocephaly received distraction osteogenesis using new 3-D distractor in the NAVID system. In two cases of anterior plagiocephaly, the reshaping of supra-orbital bar in reference of simulating by the 3-D skull model was performed. In all cases, we fixed two paralleled 2-D distractors and a 3-D distractor in the upper frontal or parietal region.
  
  
  CONCLUSIONS
  Within the limitations of this study, we believe that the NAVID system is suitable for infant plagiocephaly due to the simple and small joint arm. Furthermore, the usage of the 3-D distractor would reduce the interference with 2-D distractors and easily lead to attainment of targeted distracting distance.
authors.affiliation: Department of Neurosurgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu city, Aichi, 474-8710, Japan. hi-osawa@mub.biglobe.ne.jp.
authors.forename: Hirokatsu
authors.initials: H
authors.lastname: Osawa
authors.affiliation: Department of Neurosurgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu city, Aichi, 474-8710, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Neurosurgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu city, Aichi, 474-8710, Japan.
authors.forename: Masamune
authors.initials: M
authors.lastname: Nagakura
authors.affiliation: Department of Plastic & Reconstructive Surgery, Aichi Children's Health and Medical Center, Obu city, Aichi, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Morishita
authors.affiliation: Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Kondo
authors.affiliation: Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Kurimoto
mesh_terms: D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures; D059041:Plagiocephaly / Q000175:diagnosis* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D015898:Tomography Scanners, X-Ray Computed
keywords: 3D distractor; Craniosynostosis; Distraction osteogenesis; Plagiocephaly