Fig. 1.

a–d Pre-operative photos of patients with Muenke syndrome. a, b An 11-month-old patient with Muenke syndrome with turribrachycephaly, and a bulging forehead; c 16-month-old patient with Muenke syndrome, showing brachycephaly, with a high forehead, bulging temporal squama, and mild hypertelorism; d 45-month-old patient, showing anterior plagiocephaly due to left unilateral coronal synostosis; e three-dimensional reformatted computed tomography of a 4-month-old (same patient as c), demonstrating brachycephaly and incomplete midline ossification, as well as a shortened anterior cranial base; f tarsal bone fusion (talus-calcaneus) in a patient with Muenke syndrome (red arrow) (female, 7 years); g thimble-like intermediate second phalanx with cone-shaped epiphysis and an abnormally short intermediate fifth phalanx (female, 7 years); h carpal bone fusion (capitate-hamate) in a patient with Muenke syndrome (red arrow). (Photos a–e, g, h: courtesy of H. Collmann, and published with consent from participating patients)