Introduction: Distraction osteogenesis for the treatment of craniosynostosis is increasing as it is simpler, fewer transfusions are required, and there is decreased incidence of complications though a secondary procedure is necessary. Here, we compare early results of three operational methods in 138 children with non-syndromic craniosynostosis.

Methods: We compared 100 patients with trans-sutural distraction osteogenesis (TSuDO), 23 patients with rotating distraction osteogenesis (RDO) and 15 patients who received conventional craniotomy and remodeling (CR). The TSuDO consisted of simple suturectomy of the pathologic suture followed by direct distraction while the RDO comprised of suturectomy of the pathologic suture, and resection of the bone flap to allow wide suture separation for distraction and open-door rotation.

Results: The mean operation duration in the TSuDO group was 117.5 ± 50.48 minutes, which was significantly shorter than 255.9 ± 97.8 minutes for the RDO group or the 414.0 ± 106.9 minutes for the CR group (p<0.01). The mean transfusion volume of red blood cell in the TSuDO group was 98.4 ± 90.4 ml, which was significantly smaller than 329.8 ± 214.1 ml for the RDO group or the 451.9 ± 339.2 ml for the CR group (p<0.01). Perioperative complications comprised of 1 case (1%) of transient cranial nerve palsy, 4 cases (4%) of distractor breakage and 6 cases (6%) of minimal pus discharge in the TSuDO group, 2 cases (8.6%) of distractor breakage and 2 cases (8.6%) of minimal pus discharge in the RDO group, and 1 case (6.7%) of postoperative epidural hematoma and 1 case (6.7%) of spontaneous bone fracture in the CR group.

Conclusions: We suggest that TSuDO may be the safest and most efficient method for treating children with craniosynostosis by expanding the intracranial volume and correcting abnormal skull contour shapes especially in young children less than 2 years.

Patient Care: We try to find the best operational method which will improve patient safety and care.

Learning Objectives: TSuDO may be the safest and most efficient method for treating children with craniosynostosis especially in young children less than 2 years.

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