Force measurements during posterior calvarial vault osteodistraction: A novel measurement method

Abstract Posterior calvarial vault osteodistraction (PCVO) has become increasingly popular in the correction of craniosynostosis. When compared to cranioplasty, PCVO offers a shorter, less invasive operation, greater intracranial volume advancement and a lower rate of relapse. In general, distractio...

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Bibliographic Details
Published in:Journal of cranio-maxillo-facial surgery 2017-06, Vol.45 (6), p.981-989
Main Authors: Ritvanen, A, Savolainen, M, Nowinski, D, Saiepour, D, Paulasto-Kröckel, M, Hukki, J, Tukiainen, E, Leikola, J
Format: Article
Language:English
Subjects:
Craniosynostoses - diagnostic imaging
Craniosynostoses - surgery
Craniosynostosis
Craniosynostosis surgery
Dentistry
Female
Force measurement
Humans
Imaging, Three-Dimensional
Infant
Osteodistraction
Osteogenesis, Distraction - methods
Posterior calvarial vault osteodistraction
Radiographic Image Interpretation, Computer-Assisted
Stress, Mechanical
Surgery
Tomography, X-Ray Computed
Torque
Treatment Outcome
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Summary:Abstract Posterior calvarial vault osteodistraction (PCVO) has become increasingly popular in the correction of craniosynostosis. When compared to cranioplasty, PCVO offers a shorter, less invasive operation, greater intracranial volume advancement and a lower rate of relapse. In general, distraction protocols are based primarily on clinical observations rather than systematic research. Faster distraction protocols may reduce complications. However, distraction protocols producing higher forces can increase complications. Thus, we need to understand these forces in order to improve distraction protocols and devices. We developed a force measurement method that can be used on PCVO devices. Here, we present preliminary data about the forces developed during PCVO. We measured the forces in four bicoronal craniosynostosis patients during PCVO. We observed a linear-like trend between the force increase and the distraction distance within distraction sessions. We also observed a step-wise force increase between distraction sessions and found that the distraction force relaxed rapidly shortly after the distraction session. The mean maximum pre-distraction force for one distracter was 20.4 N, while the mean maximum end-distraction force for one distracter was 57.6 N. Our data suggests that current treatment protocols might be re-evaluated favouring shorter distraction distances and more frequent distraction sessions.
ISSN:1010-5182
1878-4119
1878-4119
DOI:10.1016/j.jcms.2017.02.013