Multi-directional Le Fort III midfacial distraction using an individual prefabricated device

Background: Midfacial distraction following Le Fort III osteotomy has become an established procedure for midfacial advancement of syndromic craniosynostosis patients. A frequent difficulty is the precise three dimensional (3D) alignment of the distracted midface and the proper fixation of the distraction device in the midfacial area. In this study we present an individual modification method for commercial distraction devices comprising the establishment of prefabricated fixation plates and parallel connecting pins. Material: Individual prefabricated fixation plates for the zygomatic buttress were combined with two commercial distraction devices. Method: The fixation plates were made by a casting technique using individual cranial models as templates. The latter were fabricated by the rapid prototyping technique of 3D powder printing. For precise realization of the distraction vector, two commercial devices were combined and attached rigidly to the fixation plates by two parallel pins. Result: In the clinical routine, the 3D powder printing technique enables the simple fabrication of precise individual cranial models, which are required for manufacturing individual fixation plates. The combination of two commercial distraction devices facilitates the appropriate transfer of complex distraction vectors into the midfacial area. Conclusion: The technique presented should be useful for a precise multi-directional midfacial distraction following Le Fort III osteotomy. (C) 2008 European Association for Cranio-Maxillofacial Surgery