Wire fixation of internal distractor for cranial vault remodeling.

BACKGROUND: Posterior cranial vault distraction osteogenesis is currently used to enlarge the cranial volume and control the intracranial pressure. This procedure carries the risk of hardware dislocation, and especially in infants, as their skull being thin, the screws may damage the underlying dura. TECHNICAL NOTE: In this paper, the authors describe a simple method to fixate the internal distractor to the skull vault in case of thin calvaria using metallic wires. DISCUSSION: This method allows a strong and tight application of the distractor to the osteotomy margins and reduces the risks of loosening of the device and the risk of dural tears. It is particularly useful in young children or in case of diffuse digitate impressions with areas of reduced thickness of the skull bone.