Retrospective study of nonsyndromic craniosynostosis treated over a 10-year period.

Since the first operation for premature suture closure in North America in 1888, there have been some fundamental changes in the treatment of these sutures, the latest being the U.S. Food and Drug Administration's 1996 approval of a bioabsorbable fixation device. This retrospective study documents our experience with procedures performed primarily by Bennie J. van R. Zeeman for isolated craniosynostosis over a 10-year period. It was an attempt to evaluate factors affecting outcome and to determine the safety of the techniques used to correct these congenital defects. Diagnoses included plagiocephaly (116) and sagittal (44), metopic (17), and bilateral coronal (12) synostosis. All patients underwent fronto-orbital advancement or calvarial vault remodeling, or both. The average patient age at time of sagittal synostosis surgery was 13.4 months; unilateral coronal synostosis, 12.2 months; deformational plagiocephaly, 9.8 months; metopic synostosis, 8.6 months; and bilateral coronal synostosis, 10.4 months. Perioperative complications were minimal, with one mortality. Postoperative complications included three cases involving infection. The problem of reoperation for the removal of wires and plates remains the greatest postoperative complication. Because of poor patient compliance, no accurate postoperative follow-up has been recorded. On the basis of our experience, we wish to point out some problems inherent in this surgery and also the complications that can occur despite careful coordinated planning and team effort.