A New, Single-Stage, Distraction-Mediated, Cranial Vault Expansion Technique for the Multisuture Deformity

Multisuture craniosynostosis with a mild cloverleaf deformity is rare but associated with high morbidity and mortality. Conventional treatment to alleviate intracranial hypertension in a young infant involves multisuturectomy and relies on passive correction of the deformity followed by additional staged reconstruction later in infancy. Early regional craniectomy and rigid reconstruction have been described, but the cranial bone has limited stability to tolerate plate fixation and extensive dissection of the bone-dura interface may devascularize the cranial bone flap and limit its durability. The authors report an interesting technique to treat a mild form of cloverleaf skull deformity using early, nondevascularizing osteotomies followed by application of semiburied cranial distractors in multiple planes to increase intracranial volume and treat the deformity, and its attendant volumetric constriction, in a single stage.