A novel technique to secure the Rigid External Distraction (RED) frame in a thin skull allowing sutural mid-face distraction

作者：Dobbs Thomas D; Wall Steven A; Richards Peter G; Johnson David^*

来源：Journal of Cranio-Maxillofacial Surgery, 2014, 42(7): 1048-1051.

DOI：10.1016/j.jcms.2014.01.027

• Distraction osteogenesis
• Rigid External Distraction frame
• Mid-face distraction
• Sutural distraction
• Bone grafting
• Craniosynostosis

Distraction osteogenesis (DO) has revolutionised the treatment of mid-face hypoplasia in children, allowing advancement of the mid-face in excess of that achievable by traditional Le Fort III osteotomy. One method of performing DO is to use an externally applied frame, such as the Rigid External Distraction (RED) frame. However, at young ages the cranial bone is often too weak to support the frame, preventing its safe use.
We present the case of a patient with Crouzon syndrome who required mid-face distraction at 4-months of age due to severe exorbitism, raised intracranial pressure and airway compromise. In order to allow safe application of an external distraction frame laminated bone grafts were secured to the cranium at the areas of frame pin insertion.
We believe this to be the first reported case of the use of the patients own cranial bone to create laminated bone grafts and thicken the site of pin insertion. The method described adds to the armamentarium of the surgeon treating these patients who require placement of an external distraction frame for DO at a young age where the thickness of the cranial bone may otherwise prevent safe application.

• 出版日期2014-10