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Use of cross-bone strut stabilization for barrel stave osteotomies in calvarial reconstruction.
J Craniofac Surg. 2010 Mar; 21(2):491-4.JC

Abstract

INTRODUCTION

Techniques using barrel stave osteotomies have become commonplace in cranial vault reconstruction. Unfortunately, the ability of the barrel staves to maintain their expanded position is dependent on the dynamics of the surrounding soft tissue envelope and the support of the underlying brain because they are not fixed transversely. This article presents the use of cross-bone strut stabilization as a modification of the barrel stave technique to minimize collapse and help maintain the desired shape of the cranial vault.

METHODS

Bone grafts harvested from the inner table of the cranial bone flaps were fashioned into rectangular struts. The struts were fit between the expanded ends of barrel staves after the desired shape and contour was achieved and fixed with resorbable plates and/or resorbable suture.

RESULTS

Eighty-six of 139 consecutive patients treated for sagittal, metopic, or lambdoid craniosynostosis had cross strut stabilization in conjunction with barrel stave osteotomies for a mean age of 9.8 months and a mean follow-up of 4.9 years. This technique provided excellent and predictable aesthetic results that resisted relapse under the constraining forces of the overlying scalp. The stabilized barrel stave cohort had 2 minor complications (2.3%) and 2 major complications (2.3%), none of which was directly related to this technical nuance.

CONCLUSIONS

In properly selected patients, cross-bone strut stabilization can enhance the stability of barrel stave osteotomies. The described technique leads to a long-lasting restoration of an aesthetically pleasing cranial shape and a sturdy framework into which the brain can expand and grow unimpeded.

Authors+Show Affiliations

Division of Plastic and Reconstructive Surgery, University of Michigan Hospital, Ann Arbor, Michigan, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20216448

Citation

Levi, Benjamin, et al. "Use of Cross-bone Strut Stabilization for Barrel Stave Osteotomies in Calvarial Reconstruction." The Journal of Craniofacial Surgery, vol. 21, no. 2, 2010, pp. 491-4.
Levi B, Kasten SJ, Buchman SR. Use of cross-bone strut stabilization for barrel stave osteotomies in calvarial reconstruction. J Craniofac Surg. 2010;21(2):491-4.
Levi, B., Kasten, S. J., & Buchman, S. R. (2010). Use of cross-bone strut stabilization for barrel stave osteotomies in calvarial reconstruction. The Journal of Craniofacial Surgery, 21(2), 491-4. https://doi.org/10.1097/SCS.0b013e3181cfecf3
Levi B, Kasten SJ, Buchman SR. Use of Cross-bone Strut Stabilization for Barrel Stave Osteotomies in Calvarial Reconstruction. J Craniofac Surg. 2010;21(2):491-4. PubMed PMID: 20216448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of cross-bone strut stabilization for barrel stave osteotomies in calvarial reconstruction. AU - Levi,Benjamin, AU - Kasten,Steven J, AU - Buchman,Steven R, PY - 2010/3/11/entrez PY - 2010/3/11/pubmed PY - 2010/9/30/medline SP - 491 EP - 4 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 21 IS - 2 N2 - INTRODUCTION: Techniques using barrel stave osteotomies have become commonplace in cranial vault reconstruction. Unfortunately, the ability of the barrel staves to maintain their expanded position is dependent on the dynamics of the surrounding soft tissue envelope and the support of the underlying brain because they are not fixed transversely. This article presents the use of cross-bone strut stabilization as a modification of the barrel stave technique to minimize collapse and help maintain the desired shape of the cranial vault. METHODS: Bone grafts harvested from the inner table of the cranial bone flaps were fashioned into rectangular struts. The struts were fit between the expanded ends of barrel staves after the desired shape and contour was achieved and fixed with resorbable plates and/or resorbable suture. RESULTS: Eighty-six of 139 consecutive patients treated for sagittal, metopic, or lambdoid craniosynostosis had cross strut stabilization in conjunction with barrel stave osteotomies for a mean age of 9.8 months and a mean follow-up of 4.9 years. This technique provided excellent and predictable aesthetic results that resisted relapse under the constraining forces of the overlying scalp. The stabilized barrel stave cohort had 2 minor complications (2.3%) and 2 major complications (2.3%), none of which was directly related to this technical nuance. CONCLUSIONS: In properly selected patients, cross-bone strut stabilization can enhance the stability of barrel stave osteotomies. The described technique leads to a long-lasting restoration of an aesthetically pleasing cranial shape and a sturdy framework into which the brain can expand and grow unimpeded. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/20216448/Use_of_cross_bone_strut_stabilization_for_barrel_stave_osteotomies_in_calvarial_reconstruction_ DB - PRIME DP - Unbound Medicine ER -