Schofield Parks (creekscarf4)

7 ± 13 and academic achievement was similar to national averages (word reading, 53.4 percent; reading comprehension, 53.4 percent; reading composite, 53.5 percent; spelling, 44 percent; and math, 52.9 percent). Radiographic measurements revealed 36 percent of patients with moderate phenotype and 64 percent with severe. Patients with severe phenotypes had lower intelligence quotient measures and scored more poorly in every academic measure tested. Word reading (113 versus 95; p = 0.035) and reading composite (109 versus 98; p = 0.014) reached significance. CONCLUSIONS Overall, cranial mature patients with metopic craniosynostosis had above average intelligence quotient and academic achievement near the national mean. Long-term neurocognitive function was correlated to preoperative radiographic severity in metopic craniosynostosis, with more severe cases performing worse. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, II.BACKGROUND The aim of this study was to evaluate the effects of the use of computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates for the correction of skeletal class III malocclusion. METHODS In this prospective, randomized, controlled clinical trial, 46 patients with skeletal class III malocclusion were randomly assigned into two groups. The patients underwent bimaxillary surgery with computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates (experimental group) or computer-aided design and manufacturing splints (control group). Preoperative and postoperative imaging data were collected and then analyzed using Mimics Research 19.0, Geomagic Studio, and IBM SPSS Version 21.0. RESULTS Deformity evaluation and posttreatment assessment were performed for all patients. The experimental group had fewer postoperative complications. Comparison of the linear and angular differences to facial reference planes revealed more accurate repositioning of the mandible and condyles in the experimental group, although the position of several landmarks still requires small adjustments. CONCLUSION Computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates effectively corrected skeletal class III malocclusion, providing positional control of segments with reasonable surgical accuracy. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.BACKGROUND Currently, the pathogenesis of leptomeningeal cysts, also known as growing skull fractures, is still debated. The purpose of this study was to examine the specific skull fracture characteristics that are associated with the development of growing skull fractures and describe the authors' institutional experience managing this rare entity. METHODS A retrospective cohort study was performed that included all patients younger than 5 years presenting to a single institution with skull fractures from 2003 to 2017. Patient demographics, cause of injury, skull fracture characteristics (e.g., amount of diastasis, linear versus comminuted fracture), concomitant neurologic injuries, and management outcomes were recorded. Potential factors contributing to the development of a growing skull fracture and neurologic injuries associated with growing skull fractures were evaluated using univariate logistic regression. RESULTS A total of 905 patients met the authors' inclusion criteria. Of these, six (0.66 percent) were diagnosed with a growing skull fracture. Growing skull fractures were more likely to be comminuted (83.3 percent versus 40.7 percent; p = 0.082) and to present with diastasis on imaging (100 percent versus 26.1 percent; p less then 0.001; mean amount of diastasis, 7.1 mm versus 3.1 mm; p less then 0.001). Univariate logistic regression analysis confirmed the role of a comminuted fracture pattern (OR, 7.572) and the degree of diastasis (OR, 2.081 per mm diastasis) as significant risk factors for the development of growing skull fractures. CONCLUSIONS The authors' analysis revea