Distraction osteogenesis and its application to the midface and bony orbit in craniosynostosis syndromes.

The purpose of this study was to demonstrate the potential advantages of applying distraction osteogenesis techniques to the correction of orbital and midfacial hypoplasia in craniosynostosis syndromes. Fifteen children with various craniosynostosis syndromes underwent Le Fort III advancement assisted by gradual distraction utilizing a pair of internal distraction devices custom-fabricated for each child. The surgical procedure consisted of a Le Fort III osteotomy, implantation of internal devices with initiation of distraction intraoperatively, and an accelerated rate of midfacial advancement over the next 3 to 5 days.

Development of an integrated case management program for vulnerable children.

Although case management is a recognized technique to organize and coordinate human services, its use with high-risk children is relatively new. This article describes the development of a case management program for children at the Center for the Vulnerable Child at Children's Hospital, Oakland, California, a health care setting that brings together health, social work, and child welfare services. Case management was introduced into multidisciplinary clinical programs for foster children, drug-exposed infants, and adolescent mothers and their infants.

Application of the Threedimensional CT Scan to the Reconstruction of Craniofacial Deformities.

New developments in computerised tomography (CT) imaging technology have paralleled advances in craniofacial surgical techniques. The ability to reconstruct congenital, neoplastic, and traumatic deformities is dependent upon good pre-operative assessment. Understanding the spatial relationship of a given deformity is limited with conventional two-dimensional CT scans.