title: Force measurements during posterior calvarial vault osteodistraction: A novel measurement method.
abstract: Posterior calvarial vault osteodistraction (PCVO) has become increasingly popular in the correction of craniosynostosis. When compared to cranioplasty, PCVO offers a shorter, less invasive operation, greater intracranial volume advancement and a lower rate of relapse. In general, distraction protocols are based primarily on clinical observations rather than systematic research. Faster distraction protocols may reduce complications. However, distraction protocols producing higher forces can increase complications. Thus, we need to understand these forces in order to improve distraction protocols and devices. We developed a force measurement method that can be used on PCVO devices. Here, we present preliminary data about the forces developed during PCVO. We measured the forces in four bicoronal craniosynostosis patients during PCVO. We observed a linear-like trend between the force increase and the distraction distance within distraction sessions. We also observed a step-wise force increase between distraction sessions and found that the distraction force relaxed rapidly shortly after the distraction session. The mean maximum pre-distraction force for one distracter was 20.4 N, while the mean maximum end-distraction force for one distracter was 57.6 N. Our data suggests that current treatment protocols might be re-evaluated favouring shorter distraction distances and more frequent distraction sessions.
authors.affiliation: Department of Electrical Engineering and Automation, School of Electrical Engineering, Aalto University, PO Box 13000, 00076 Aalto, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Ritvanen
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, PO Box 266, 00290 HUS, Finland. Electronic address: savolainen_mikko@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Savolainen
authors.affiliation: Craniofacial Centre, Uppsala University Hospital, Akademiska sjukhuset ing 85, 9tr 75185 Uppsala, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Nowinski
authors.affiliation: Craniofacial Centre, Uppsala University Hospital, Akademiska sjukhuset ing 85, 9tr 75185 Uppsala, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Saiepour
authors.affiliation: Department of Electrical Engineering and Automation, School of Electrical Engineering, Aalto University, PO Box 13000, 00076 Aalto, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Paulasto-Kröckel
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, PO Box 266, 00290 HUS, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Hukki
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, PO Box 266, 00290 HUS, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Tukiainen
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, PO Box 266, 00290 HUS, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Leikola
mesh_terms: D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D019857:Osteogenesis, Distraction / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D019415:Torque; D016896:Treatment Outcome
keywords: Craniosynostosis; Craniosynostosis surgery; Force measurement; Osteodistraction; Posterior calvarial vault osteodistraction