An alternative plate and screw method of advancement of the supraorbital osteotomy bar in cranial remodelling surgery for craniosynostosis is described. The lateral orbital rim is transversely cut and using miniplates, screws are implanted into its advanced cut ends. Appropriate screws and miniplates are used to suit the size of the orbital rim in patients of different age groups. The technique was used in 12 cases and the authors have found the results extremely gratifying. It offered the advantage of providing a firm, secure and desired advancement, and height of the supraorbital bar maintaining a smooth lateral rim contour. The procedure was technically relatively straightforward. Further observation is warranted to determine whether the stabilization will last into adulthood or if there will be any problem related to the metal screws and plates.
Department of Neurosurgery, King Edward Memorial Hospital and Seth G. S. Medical College, Parel, Mumbai, India and Shinshu University School of Medicine, Matsumoto, Japan. atulgoel62@hotmail.com