Lack of ossification after cranioplasty for craniosynostosis: a review of relevant factors in 592 consecutive patients

J Craniofac Surg. 1993 Oct;4(4):247-54; discussion 255-6.

Abstract

The Center for Craniofacial Anomalies of Necker-Enfants-Malades Hospital presents a retrospective study of the outcome of 592 patients who were operated on for craniosynostosis between 1976 and 1991. The quality of ossification 1 year after operation is reported, with a focus on influencing factors. The lack of ossification rate was 5% (30 of 592). Three parameters are identified as increasing the risk of poor osseous wound healing: local postoperative infection; forehead advancement, especially when accomplished with resorbable osteosynthesis; and brachycephaly. In contrast, repaired tears of the dura mater do not seem to pose a risk. Seventy-five percent of patients with local infection and 12.4% with forehead advancement presented a lack of ossification, which is statistically significant (p < 0.001). Lack of ossification can compromise aesthetic and functional results. Decreasing postoperative infection and stable fixation may help promote ossification.

MeSH terms

  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Craniosynostoses / surgery*
  • Dura Mater / injuries
  • Humans
  • Infant
  • Infant, Newborn
  • Osteogenesis*
  • Postoperative Complications*
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection
  • Treatment Failure