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Cranial distraction osteogenesis: a proposal of minimal consolidation period

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Abstract

Purpose

Cranial distraction osteogenesis (DO) has many advantages for correcting skull deformities: Thus, DO is extensively used for the treatment of skull deformities. However, diverse, unexpected complications are associated with this procedure. In this study, we present the surgical outcomes and complications of DO. Moreover, we propose a modified protocol for DO to reduce complications.

Methods

This is a retrospective study on managed patients that underwent DO between March 2008 and May 2013. Their clinical courses were reviewed. Distraction protocols were individually inspected, and the final surgical outcomes, including complications, were evaluated.

Results

During the study period, a total of ten patients (seven boys and three girls) were treated at our institute. The median distraction period was 20.5 days (ranging from 17 to 50 days). The range of total distraction length was 19–22 mm. The median consolidation period was 96 days (ranging from 0 to 343 days). All patients achieved the goals of distraction. At follow-up evaluations, all patients, except one, showed good surgical outcomes in both head shape and neurologic symptoms. There were six patients with wound complications during the treatment period. Among them, the distractors were removed early in three patients. Interestingly, even these three patients, without a sufficient consolidation period, showed good outcomes.

Conclusions

Although DO has many merits for correcting skull deformities, it frequently causes severe wound complications. To reduce these complications, we propose a modified protocol with a minimal or even no consolidation period.

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Acknowledgment

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A120099).

Conflict of interest

Authors have nothing to disclose, and there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

    Jung Won Choi, Ji Yeoun Lee, Ji Hoon Phi, Seung-Ki Kim & Kyu-Chang Wang

  2. Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea

    Jung Won Choi, Ji Yeoun Lee, Ji Hoon Phi, Seung-Ki Kim & Kyu-Chang Wang

  3. Department of Plastic and Reconstructive Surgery, Seoul National University Hospital & Seoul National University College of Medicine, Seoul, Republic of Korea

    Tae Hyun Choi & Sukwha Kim

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  1. Jung Won Choi
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  2. Ji Yeoun Lee
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  3. Ji Hoon Phi
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Correspondence to Kyu-Chang Wang.

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Choi, J.W., Lee, J.Y., Phi, J.H. et al. Cranial distraction osteogenesis: a proposal of minimal consolidation period. Childs Nerv Syst 31, 751–757 (2015). https://doi.org/10.1007/s00381-014-2607-0

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  • DOI: https://doi.org/10.1007/s00381-014-2607-0

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