The faith of a coronal suture grafted onto midline synostosis inducing dura and deprived from tensile stress

Objective: To discuss possible reasons for the synostosis of a coronal sutu re that was transplanted onto synostosis inducing dura in a scaphocephalic human cranium. Design: Case report. Setting: Supraregional teaching hospital, center for craniofacial anomalies . Patient. A bathmocephalic boy, followed from age 7 1/2 to 26 months. Intervention: Radical synostosectomy, radial osteotomies in the parietal bo ne with outward fracturing of the barrel staves, and left-sided coronal sut ure transplantation onto the midline was undertaken at the age of 11 months . Methods: Computer tomography and clinical follow-up. Results: The sutural graft, initially deprived from tensile stress and quic kly exposed to the anomalous dura, turned synostotic in one year. Conclusions: Both cell signaling and biomechanical theories on calvarial mo rphogenesis, sutural development, and synostosis can apply. An animal exper iment is recommended to test which hypothesis prevails.