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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Posterior vault distraction osteogenesis: indications and expectations.

Anna R Carlson1, Jesse A Taylor2

  • 1Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 20, 2021
PubMed
Summary

Posterior cranial vault distraction osteogenesis (PVDO) effectively expands intracranial volume in craniosynostosis patients, offering superior results compared to anterior cranial vault remodeling. This safe and established technique is increasingly preferred for infants with syndromic craniosynostosis.

Keywords:
Cranial vault reconstructionCraniosynostosisDistraction osteogenesisPosterior cranial vault distraction osteogenesis

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Area of Science:

  • Craniofacial surgery
  • Pediatric neurosurgery
  • Orthopedic surgery

Background:

  • Craniosynostosis requires cranial vault remodeling (CVR) to correct skull shape and manage intracranial pressure.
  • Distraction osteogenesis, a technique for bone lengthening, has been adapted for craniofacial applications.
  • Posterior cranial vault distraction osteogenesis (PVDO) was developed to enhance intracranial volume expansion.

Purpose of the Study:

  • To evaluate the safety and efficacy of posterior cranial vault distraction osteogenesis (PVDO) in treating craniosynostosis.
  • To compare the outcomes of PVDO with traditional anterior cranial vault remodeling procedures.
  • To assess the suitability of PVDO for a wide range of patients with syndromic and non-syndromic craniosynostosis.

Main Methods:

  • Review of existing literature on PVDO and cranial vault remodeling techniques.
  • Analysis of studies comparing PVDO with anterior cranial vault remodeling (FOAR).
  • Assessment of perioperative morbidity and long-term outcomes in patients undergoing PVDO.

Main Results:

  • PVDO provides significantly greater intracranial volume expansion than anterior cranial vault remodeling.
  • PVDO improves both posterior and anterior cranial vault morphology.
  • Perioperative major morbidity associated with PVDO is comparable to conventional remodeling.
  • PVDO is safe and effective for patients of all ages with syndromic and non-syndromic craniosynostosis.

Conclusions:

  • PVDO is a safe and effective procedure for cranial vault expansion in craniosynostosis.
  • PVDO offers superior intracranial volume increases compared to anterior cranial vault remodeling.
  • Many centers consider PVDO the preferred initial surgical option for infants with syndromic craniosynostosis.