We have developed a hybrid facial osteogenesis distraction system that combines the advantages of external and internal distraction devices to enable control of both the distraction distance and vector. However, when the advanced maxilla has excessive clockwise rotation and shifts more downward vertically than planned, it might be impossible to pull it up to correct it. We invented devices attached to external distraction systems that can control the vertical vector of distraction to resolve this problem. The purpose of this article is to describe the result of utilizing the distraction system for syndromic craniosynostosis.
In addition to a previously reported hybrid facial distraction system, the devices for controlling the vertical direction of the advanced maxilla were attached to the external distraction device. The vertical direction of the advanced maxilla can be controlled by adjustment of the spindle units. This system was used for 2 patients with Crouzon and Apert syndrome.
The system enabled control of the vertical distance, with no complications during the procedures. As a result, the maxilla could be advanced into the planned position including overcorrection without excessive clockwise rotation of distraction.
Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled.
From the *Department of Plastic and Reconstructive Surgery, Knagawa Children’s Medical Center, Yokohama, Kanagawa, Japan; †Fukawa Orthodontic Clinic, Ofuna, Kanagawa, Japan; ‡Hirakawa Orthodontic Clinic, Yokohama, Kanagawa, Japan; and §Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.
Received for publication August 23, 2013; accepted January 13,2014.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. This work was supported by grant from Grant-in-aid for Developmental Scientific Research, The Ministry of Education, Science and Culture (No. 20592101), and Health and Labour Sciences Research Grants Research on intractable disease (No. 2011–164). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The Article Processing Charge was paid for by the authors.
Shinji Kobayashi, MD Department of Plastic and Reconstructive Surgery Knagawa Children’s Medical Center Mutsukawa 2-138-4 Minami-ku, Yokohama Kanagawa 232–8555 Japan. E-mail: firstname.lastname@example.org
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