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Surgical Treatment of Nonsyndromic Craniosynostosis. J Craniofac Surg 2017 Oct;28(7):1752-1756 PMID: 28885444

Pubmed ID





Studies on the treatment of nonsyndromic craniosynostosis demonstrate decreasing morbidity and mortality; however, complication rates still range from 5% to 14%. Here, the authors present their last 10 years' experience treatment of nonsyndromic single suture craniosynostosis. A retrospective review was performed on patients who underwent open surgical treatment of nonsyndromic craniosynostosis over 10 years. Patient characteristics and clinical outcomes were reviewed. Radiological analysis of intracranial volumes was performed using Amira software. The authors' technique for treatment of sagittal synostosis was the Foreshortening and Lateral Expansion of the Cranium Activated by Gravity (FLAG) procedure. The authors identified 106 patients with a median age of 0.8 years. Sagittal synostosis was most common (n = 65, 61%). Seventeen percent underwent distraction of the cranial vault; the remainder underwent traditional remodeling procedures. The average operative time was 131 minutes, blood loss was 296 mL (30 mL/kg), and intraoperative transfusion was 332 mL (34 mL/kg). There were 2 postoperative complications. Six patients required an additional major operation years later, most commonly for increased intracranial pressure. The authors separately analyzed 50 patients with sagittal synostosis treated with the FLAG procedure. There were no postoperative complications, and only 4 patients required reoperation. The average operative time for the FLAG procedure was 97.3 minutes. Intracranial volume increased by 191.45 mL (28.3-427.5 mL) with 28% average relative cranial vault expansion (4.5%-93.2%). Surgical correction of craniosynostosis using the FLAG technique is safe and effective with minimal morbidity and long standing results. Treatment should involve a structured approach, which minimizes operative times and decreases complication rates.

Author List

Klement KA, Adamson KA, Horriat NL, Denny AD


Karri A. Adamson MD Assistant Professor in the Plastic Surgery department at Medical College of Wisconsin
Kristen Ann Klement MD Assistant Professor in the Plastic Surgery department at Medical College of Wisconsin



MESH terms used to index this publication - Major topics in bold

Intracranial Hypertension
Postoperative Complications
Retrospective Studies
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e