Endoscopic-Assisted Osteotomy with Absorbable Plate as Internal Attachment Point for External Spring Distraction
Weimin Shen1, Jie Cui1, Ji Yi1
1Department of Burn and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Insights
External spring traction using absorbable plates effectively treats sagittal synostosis in infants. This safe and reliable method corrects head shape within a year, offering an excellent treatment option.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Medical Device Innovation
Background:
- Sagittal synostosis (SS) involves premature closure of sagittal sutures in infants.
- Current treatments aim to correct abnormal head shape and allow brain growth.
- Novel methods are explored to improve surgical outcomes and patient recovery.
Purpose of the Study:
- To investigate absorbable plates as internal attachment points for external spring traction in treating SS.
- To clarify the indications and advantages of this innovative treatment approach.
- To compare the efficacy and safety of external spring (ES) versus internal spring (IS) distraction methods.
Main Methods:
- Spring-assisted therapy applied to 24 infants (3-9 months) with SS, divided into ES and IS groups.
- ES group utilized endoscopic-assisted resection and absorbable plates for spring fixation.
- IS group served as the control; cephalic index and infection rates were compared.
Main Results:
- All 24 infants showed satisfactory outcomes at 1-year follow-up.
- Cephalic index normalized, and head shape was corrected within one year in the ES group.
- No statistically significant differences in outcomes or infection rates were observed between ES and IS methods.
Conclusions:
- Endoscope-assisted osteotomy with absorbable plates for ES distraction is a novel treatment for SS.
- The method is safe, reliable, and demonstrates improved efficacy with 36-month follow-up.
- This approach represents an excellent treatment option for infants with sagittal synostosis.
Background:
Sagittal synostosis (SS) is the premature closure of sagittal sutures. To investigate the use of absorbable plates as internal attachment points for external spring (ES) traction in the treatment of sagittal craniosynostosis in infants, as well as clarify the indications and advantages of the method.
Methods:
The spring-assisted therapy was applied to treat SS in 24 infants aged between 3 and 9 months. The therapy was divided into 2 groups. One group used ES for 12 children, and the other group used internal springs (IS) for 12 children. The ES group used the ES and traction point absorbent plate fixation method. The procedure is initiated with the endoscopic-assisted resection of the fused sagittal suture. The distraction point was fixed onto an absorbable plate, and 1-0 nylon or steel wire was used to pull out the scalp, after which the ES was hung on the distraction. After 3 months of fixation, the nylon thread was cut, and the ES was removed without anesthesia. IS group serves as the control group. We compared cephalic index outcomes and infection rates in our 12 cases of SS treated with an IS versus a control group. The differences did not reach statistical significance (P > 0.05).
Results:
Twenty-four infants with SS were treated. Twelve infants with SS using an ES distraction with the traction point fixed to an absorbable plate. All of the patients showed satisfactory appearances at 1-year follow-up examinations, and all of their cephalic index had returned to normal, and the head shape was essentially corrected within 1 year. There is no significant difference between the 2 methods.
Conclusions:
The endoscope-assisted osteotomy plus absorbable plate as the interior attachment point for ES distraction is a novel way to treat SS in infants. Our 36-month follow-up showed even better efficacy, however, while remaining safe and reliable. It therefore represents an excellent treatment option for SS in infants.
