Cranioplasty with Absorbable Plates for Craniosynostosis

ABSTRACT

With the introduction of smaller metallic plating systems, many surgeons have adopted their use for craniofacial procedures in infants and small children. However, this metallic plating system had problems associated with the use of plates and screw in infants and children. These problems include intracranial migration of material, cranial growth restriction, foreign body reaction and infection. Absorbable plating system has been used as solution of these problems. In this study, absorbable plates (BioSorbFX, BIONX IMPLANTS inc.) composed of a copolymer of polylactic and polyglycolic acid were used in the reconstruction of pediatric craniofacial deformities. In 4 patients who were diagnosed with craniosynostosis between 10 and 36 months of age, absorbable plates were implanted. Follow-up periods were from 6 months to 18 months. Postoperatively, circumferential length of head was increased and cranial bone growth was symmetric. No complications were seen with this use, including infection, overlying soft tissue reaction, reconstructive instability, or underlying osteolysis around the screws. In secondary reconstructive surgery of patient with Crouzon's disease, we found out that no residual traces of polymer were evident visually and all osteotomy sites were healed completely without underlying osteolysis. These results demonstrate the safety and effectiveness of this copolymeric material for pediatric craniofacial applications.