Multidirectional cranial distraction osteogenesis（MCDO）法

Multidirectional Cranial Distraction Osteogenesis for Craniosynostosis

Point

・MCDO法は，タイル状に分割した頭蓋骨を頭部に装着したフレームに接続し，多方向に延長する独自の骨延長法である．

・少ない延長距離でも十分な容積拡大が可能で，頭蓋形態をみながら延長方向をアレンジできるという利点がある．

・骨のギャップが少ないため保定期間が短く，延長器を外す手技も容易であるという利点もある．

　In this article we explain in detail the Multidirectional Cranial Distraction Osteogenesis（MCDO）procedure for treating craniosynostosis, in which the multiple cranial bone flaps are pulled up in different directions by the external distractor with the helmet-type frame. MCDO has several advantages over conventional procedures such as unilateral cranial distraction osteogenesis（UCDO）. First, the design of the osteotomy in MCDO is flexible depending on the deformities. Each bone flap can be moved to the desired direction in MCDO, while being moved only in one direction along the axis of the distractor in UCDO. This enables remodeling of the deformed cranium to the desired shape. Second, compared with UCDO, the distance between each bone flap after distraction is narrower in MCDO, allowing earlier bone formation and fusion, and thus a shorter consolidation period. Third, the expansion efficacy of MCDO is greater than that of UCDO. The maximum defects of MCDO were the large amount of osteotomy and the resulting heavy bleeding. Therefore, we have recently attempted to improve the design and procedure of osteotomy. The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis.