Reconstruction of Combined Orbital Floor and Medial Wall Fractures Using Custom-Made Titanium Alloy Implant.

ABSTRACT: The reconstruction of combined orbital floor and medial wall fractures is challenging due to the surgical approach and implant stability. A 0.5 mm thickness rigidity custom made titanium alley implant was created by 3-dimensional printing with electron-beam additive manufacturing. The implant was designed to cover the entire surface of the inferomedial orbit based on the flipped the contralateral orbit images. Although the cost was expensive, the use of three-dimensional printed implants for extensive orbital wall fractures was useful for decreasing operative time, and can be accessed with a limited surgical approach with a precise fit.

Delayed-Onset Familial Sagittal Suture Synostosis.

Sagittal craniosynostosis is the most common of all craniosynostoses. Patients with sagittal craniosynostosis exhibit a typical cranial appearance, including scaphocephaly, and an elongated head, with a fused and ridged sagittal suture. Moreover, some recent reports described atypical sagittal craniosynostosis accompanied by autism, speech delay, and hyperactivity. This condition, known as delayed-onset craniosynostosis, is rarely reported, given that it is difficult to determine if the condition is congenital or has a delayed-onset.This report describes the clinical course and treatment of 2 brothers with atypical sagittal synostosis. The shapes of their heads were not indicative of scaphocephaly and the younger brother exhibited delayed-onset sagittal synostosis. Their father and paternal grandmother exhibited similar cranial morphologies. Therefore, we hypothesized the involvement of a familial factor in the etiology of atypical sagittal synostosis in these patients.

Ectopic salivary gland fistula in the sternoclavicular joint region.

Although rare, ectopic salivary gland fistula should be considered in the differential diagnosis when treating a fistulous lesion on the neck because its natural history and the level of difficulty of surgery are different from those of the branchial fistula.

Distraction Osteogenesis for Brachymetatarsia by Using Internal Device.

Congenital brachymetatarsia most commonly involves the fourth ray and may be combined with metacarpal shortening. Now, many reports demonstrated the usefulness of distraction osteogenesis for lengthening of the metatarsals by using an external distraction device. In this article, we treated shortening fourth metatarsal by bone lengthening using the internal distraction device. This technique has some advantages over the method of external distraction.