Cranial bones sutures

William Gamer Sutherland was another student of Still. When the grooves in the suture of a temporal bone caught his eye, he was led to believe that the cranial bones mnst be capable of motion. He likened them to the "gills of a fish." He thns began the stody of cranial osteopathy and spent many years developing its theories and techniqnes, nsed today as a specialized form of osteopathy. 

Structure of the cranial sutures allows various types of motion between contiguous bones. The nature of the sutures is discussed further in Section X, Chapter 102, as is the motion characteristics of the various cranial bones. 

The newborn skull has no interlocking sutures. The only fully formed joint in the cranium is that between the condyles of the occiput and the atlas. A newborn s cranial bones develop within dura, and the shape of the skull is maintained by dura, by fluid, and by the central nervous system s motion within. Developmentally before bone formation, membranes provide shape and protection and also guide and limit motion. 

The external layer of dura is the internal periosteum of cranial bones, the pericranium. Pericranium is continuous with periosteum of sutures and foramina, and with the external periosteum of the cranial bones. Compressive and tensile forces generated on the dura by the growing brain stimulate the membranous connective tissue to form bone between these layers of the dura. Therefore, the bones of the cranium develop within iayers of dural membrane. 

Opperman, L.A., Passarelli, R.W., Morgan, E.P., Reintjes, M., Ogle, R.C. 1995. Cranial sutures require tissue interactions with dura mater to resist osseous obliteration in vitro. J. Bone Miner. Res. 10,... 

PDS demonstrated no acute or toxic effects on implantation, and thus has been used in a number of clinical applications ranging from suture materials to bone fixation devices. Johnson and Johnson Orthopedics provides an absorbable pin for fracture fixation, and bone pins have been introduced into the market under the names OrthoSorb and Ethipin, respectively, in the USA and Europe. In craniofacial applications, the structure of PDS has been examined clinically in cranial vault procedures with promising results. Advantages include the absence of observed intracranial translocation, acceptable aesthetic outcomes and low complication rates. Nevertheless,... 

The neonatal form presents as a skeletal disorder with bent bones, soft, undermineralized skull, and respiratory distress because of soft and dysplastic ribs. The infantile form can present unspecifically as poor feeding, failure to thrive, signs of rickets, flail chest and - most importantly - signs of elevated intracranial pressure. Apparently, the mineralization defect results in growth arrest of the cranial sutures ( functional craniosynostosis). In adults, mild hypophosphatasia may present as recurrent stress fractures and so-called pseudofractures (looser zones). In both children and adults, premature loss of teeth may be a sign of hypophosphatasia. 

The cytotoxic, mutagenic, and sensitizing potential of the cranial plate was evaluated in a series of in-vitro and in-vivo studies. The poly(L-lactide) rivet/pins were not evaluated for biocompatibility because PLA containing devices have been shown to be biocompatible when implanted in animals and because of the long clinical history of safe use of various of PLA devices including bone screws and suture anchors. 

A 3 cm long mid-sagital incision was made through the skin and galea. The periosteum was elevated and an 8-mm diameter trephine craniotomy was made inunediately proximal to the coronal suture in the parietal bone, without dural involvement. The circular cranial plates were secured to the skull and the soft tissues were closed with 4-0 Vicryl suture using simple interrupted stitches. The skin wound was closed in a standard manner with staples. 

Tantalum is completely inert to body fluids and tissues. Bone and tissue do not recede from tantalmn, and this biocompatibility makes it an attractive material for body and dental implants. However, the superior strength and rigidity of stainless steel and titanimn and the castabUity of high-cobalt alloys have led to their greater use for prosthetic devices. Tantalmn has nevertheless been used for bone replacement and repair, for cranial repair plates, suture wire, and wire gauze for abdominal muscle support in hernia smgery. ... 

Another example of a genetic mutation in a lysosomal cathepsin that causes a specific human disorder has recently come to light [43]. The disease is pycnodysos-tosis which is an autosomal recessive skeletal dysplasia. Clinical features of pycno-dysostosis were first described in 1962 by Maroteaux and Lamy [60] to include bone fragility, dental abnormalities, reduced stature and skull deformities with a delay in closure of the cranial sutures. The disease experienced considerable acclaim due to the initial prediction by Maroteaux and Lamy, recently refuted [61], that this was the genetic disorder suffered by the famous French impressionist artist Toulouse-... 

---