Ten-Year Follow-Up of the “One-Wing” and “Open-Wings” Surgical Techniques in the Treatment of Craniosynostosis: A Retrospective Comparative Analysis

This retrospective comparative study assessed the long-term safety and effectiveness of 2 targeted fronto-orbital remodelling techniques, "One-Wing" for unilateral coronal synostosis and "Open-Wings" for metopic synostosis, against conventional fronto-orbital advancement (FOA). Forty patients with nonsyndromic anterior plagiocephaly or trigonocephaly met strict criteria for a 10-year follow-up: 20 consecutive cases treated with One-Wing/Open-Wings and 20 historical FOA controls all operated on by the same craniofacial team. Compared with FOA, the innovative techniques significantly shortened operative time and hospital stay, reduced mean blood loss by 125 mL, and lowered transfusion rates 4-fold. Early complication rates were similarly low across groups. At 10 years, One-Wing/Open-Wings provided durable cranial remodelling, yielding a larger mean cephalic-index gain (13.2% versus 8.2%) and no reoperations, whereas 30% of FOA patients required secondary surgery. Patient-reported outcomes mirrored these findings: aesthetic satisfaction averaged 8.8/10 versus 6.5/10, and SF-36 physical and mental component scores were markedly higher in the minimally invasive cohort. KINDL surveys confirmed superior health-related quality of life in younger patients, particularly for self-esteem and emotional well-being. These data indicate that One-Wing and Open-Wings combine the perioperative advantages of limited osteotomies with outstanding decade-long morphologic stability and psychosocial benefit, supporting their adoption as first-line options for selected nonsyndromic craniosynostoses.​​.