Rotating distraction osteogenesis in 23 cases of craniosynostosis: comparison with the classical method of craniotomy and remodeling.

Abstract

BACKGROUND: The currently employed technique of distraction osteogenesis (DO) for the surgical treatment of craniosynostosis (CS) is commonly performed due to advantages such as shorter operation time, less bleeding and thus less need for transfusions and a lower risk of infections. Several surgical techniques for the various types of CS have been reported, but a uniform surgical method is as yet unavailable.

METHODS: We compared 23 patients who underwent rotating DO (RDO) with 15 patients who received conventional craniotomy and remodeling (CR). RDO consisted of suturectomy of the pathologic suture and resection of the bone flap to allow wide suture separation for distraction and open-door rotation.

RESULTS: The mean operation duration in the RDO group was 255.9 +/- 97.8 min, which was significantly shorter than the 414.0 +/- 106.9 min for the CR group (p = 0.0001). Perioperative complications in the RDO group consisted of 2 cases of distractor breakage and 2 cases of minimal pus discharge, while in the CR patients there was 1 case of postoperative epidural hematoma and 1 case of spontaneous bone fracture.

CONCLUSION: We suggest that RDO may be a valid and efficient method for treating children with CS by DO by expanding the intracranial volume and correcting abnormal skull contour shapes.