Split plate technique in the fixation of remodelled cranial bones in infants

Abstract

t b c e describe a modification in the technique of absorbable iniplate fixation for the correction of craniosynostosis, hich involves the use of posteriorly unfixed, but split etained miniplates to stabilise surgically remodelled cranial one in children. Fronto-orbital remodelling is a technique used in the mangement of anterior simple craniosynostosis.1,2 After frontal raniotomy of a D-shaped portion of the frontal bones, a baneau of the supra-orbital rim and inferior aspect of the frontal ones is removed and remodelled on the side table where the urvature can be accurately shaped. When reapplied to the pper nasal bone or glabella, the angulation of the frontonasal one and the forward projection of the new anterior cranial orm can be set. Arguably, microplating techniques provide better threeimensional control than wire fixation, but many surgeons hink that wires or sutures, or both, are adequate, and that rigid xation is not necessary. Certainly there are disadvantages in hildren: the plates and screws can migrate3 and osseointerate, which causes problems if they require removal because f infection, are palpable under the skin, or become lodged n dura.3 The plates may also cause a secondary disturbance 4 f growth. The advent of resorbable plating systems overcame some f these disadvantages with good long-term results.5 How-