Dissolving Doubts: Resorbable Fixation in Posterior Vault Distraction Osteogenesis

Le résumé fourni par la source

Posterior cranial vault distraction osteogenesis (PVDO) traditionally requires titanium screw fixation of metallic distractor footplates. Cho and colleagues recently described an off-label application of the Synthes RapidSorb Injectable Polymer System for footplate fixation in PVDO, reporting reduced distractor removal operative time in an initial single-institution series. This study expands that cohort and further evaluates operative outcomes across a multisurgeon institutional experience. Retrospective review identified consecutive PVDO patients treated between 2013 and 2025. The most recent patients in each fixation cohort were included; patients undergoing concurrent procedures at distractor removal were excluded. The primary outcome was the distractor removal operative time. Multivariable regression and within-surgeon analyses were performed to assess surgeon and era confounding. Among 84 patients (42 titanium; 42 resorbable [27 full IPS, 15 hybrid]), resorbable fixation was associated with a 25.4% reduction in removal operative time (37.4±12.6 versus 50.2±16.1 min; mean difference 12.8 min, 95% CI: 6.5-19.0; P<0.001). The effect was robust to year adjustment (P<0.001) and demonstrated within a single surgeon's practice (P<0.001). No instances of fixation system failure occurred. Wound complications did not differ significantly between groups (P=0.41). In the largest comparative experience reported to date, off-label application of the Rapidsorb IPS for cranial distractor fixation in PVDO was associated with reduced removal operative time without fixation failure, extending the favorable on-label safety profile of the 85:15 PLG copolymer into the higher-mechanical-demand setting of cranial vault distraction.

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