TY - JOUR
T1 - Using bioabsorbable fixation systems in the treatment of pediatric skull deformities leads to good outcomes and low morbidity
AU - Hayden Gephart, Melanie G.
AU - Woodard, Joslyn I.
AU - Arrigo, Robert T.
AU - Lorenz, H. Peter
AU - Schendel, Stephen A.
AU - Edwards, Michael S.B.
AU - Guzman, Raphael
N1 - Funding Information:
Acknowledgments This research was supported in part by an indirect educational grant from Synthes to Stanford University School of Medicine. Additional funding was from the Division of Pediatric Neurosurgery at Stanford University and Lucile Packard Children's Hospital.
Funding Information:
Funding was provided in part by an industry sponsored indirect educational grant to Stanford University to fund aspects of this study. The Synthes company administration and representatives had no contact with the study staff regarding the study design or results. Furthermore, the outcome of this study was not discussed with industry prior to data analysis or manuscript production. Ethical considerations of this educational grant were weighed heavily and ultimately approved by the Dean of the Stanford University School of Medicine.
PY - 2013/2
Y1 - 2013/2
N2 - Background: Bioabsorbable fixation systems have been widely employed in pediatric patients for cranial reconstruction, obviating the complications of hardware migration and imaging artifact occurring with metallic implants. Recent concern over complications unique to bioabsorbable materials, such as inflammatory reaction and incomplete resorption, necessitates additional conclusive studies to further validate their use in pediatric neurosurgery and craniofacial surgery. Likewise, long-term follow-up in this clinical cohort has not previously been described. Methods: We included consecutive pediatric patients under the age of 2, from Lucile Packard Children's Hospital, who underwent cranial vault reconstruction with the use of a bioabsorbable fixation system between 2003 and 2010. Hospital records were queried for patient characteristics, intraoperative data, and postoperative complications. Results: Ninety-five patients with the following preoperative pathologies were analyzed: craniosynostosis (87), cloverleaf skull (5), frontonasal dysplasia (1), and frontonasal encephalocele (2). Median age was 6 months (range 1-24 months). Average case duration was 204 minutes (range 40-392 min), with median of 154 mL blood loss (range 30-500 mL). Ninety-three percent of patients had 1-4 plates implanted with 48 % receiving three plates. The median number of screws used was 59 (range 0-130). The median length of hospital stay was 4 days (range 2-127 days) with an average follow-up of 22 months (five postoperative visits). The complications related to hardware implantation included swelling (1 %) and broken hardware (1 %), the latter of which required reoperation. Discussion: The bioabsorbable fixation systems for cranial vault reconstruction in children less than 2 years of age is safe with tolerable morbidity rates.
AB - Background: Bioabsorbable fixation systems have been widely employed in pediatric patients for cranial reconstruction, obviating the complications of hardware migration and imaging artifact occurring with metallic implants. Recent concern over complications unique to bioabsorbable materials, such as inflammatory reaction and incomplete resorption, necessitates additional conclusive studies to further validate their use in pediatric neurosurgery and craniofacial surgery. Likewise, long-term follow-up in this clinical cohort has not previously been described. Methods: We included consecutive pediatric patients under the age of 2, from Lucile Packard Children's Hospital, who underwent cranial vault reconstruction with the use of a bioabsorbable fixation system between 2003 and 2010. Hospital records were queried for patient characteristics, intraoperative data, and postoperative complications. Results: Ninety-five patients with the following preoperative pathologies were analyzed: craniosynostosis (87), cloverleaf skull (5), frontonasal dysplasia (1), and frontonasal encephalocele (2). Median age was 6 months (range 1-24 months). Average case duration was 204 minutes (range 40-392 min), with median of 154 mL blood loss (range 30-500 mL). Ninety-three percent of patients had 1-4 plates implanted with 48 % receiving three plates. The median number of screws used was 59 (range 0-130). The median length of hospital stay was 4 days (range 2-127 days) with an average follow-up of 22 months (five postoperative visits). The complications related to hardware implantation included swelling (1 %) and broken hardware (1 %), the latter of which required reoperation. Discussion: The bioabsorbable fixation systems for cranial vault reconstruction in children less than 2 years of age is safe with tolerable morbidity rates.
KW - Bioabsorbable
KW - Craniosynostosis
KW - Pediatric neurosurgery
KW - Pediatric skull deformities
KW - Resorbable plates
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U2 - 10.1007/s00381-012-1938-y
DO - 10.1007/s00381-012-1938-y
M3 - Article
C2 - 23099613
AN - SCOPUS:84878521758
SN - 0256-7040
VL - 29
SP - 297
EP - 301
JO - Child's Nervous System
JF - Child's Nervous System
IS - 2
ER -