The Correction of Plagiocephaly

Abstract

Real Plagiocephaly is a rare form of craniosynostosis, resulting from the premature fusion of the coronal suture on one side, leading to a deformed head and to an apparently exteriorized homolateral eye. We present a simple and straightforward technique, based on removal of the involved suture, with the surgical incision prolonged to the orbital roof till near the ethmoide. After having sectioned the lateral border of the orbit at the junction of the zygomatic and frontal bones, a paramedian incision is made on the frontal bone, from the anterior fontanel (always carefully preserved), till the glabella. Then follows simple osteoclasia of the frontal bone and placement of a bone graft obtained from the adjacent parietal bone and that will maintain the forward projection of the frontal bone (but in slight hypercorrection). The grafts are simply fixed with silk sutures, placed through perforating holes in the bones, no metal being used. The transverse surgical wound, going almost from ear to ear, is closed in the usual way.