Cranioplasty with split lateral skull plate segments for reconstruction ofskull defects

This paper reports the use of cranioplasty using segments of split lateral skull plate to correct large skull defects (larger than 8 x 8 cm), The subj ects consisted of 10 patients with head trauma who had undergone decompress ion surgery, and two patients who had undergone tumour resection, Bone graf ts were obtained by cutting approximately 2 cm wide strips from the lateral skull plate using a bone sam that was inserted from a free margin of the b one defects. By cutting strips laterally from the bone defect, the necessar y amount of split lateral skull plate can be obtained without performing cr aniotomy The pieces of split lateral skull plate are then fixed to the defe ct using wire or titanium mini-plates. At this point, the selection of bone grafts that match the curvature of the dura mater is important, so that no dead spaces are created between the dura mater and the bone grafts, Infect ion was not detected in any of the 12 patients, and all bone grafts took co mpletely One of the 12 patients suffered from a pathological fracture and b one resorption 6 months after surgery The fracture occurred because the use of basket-shaped reconstruction plates resulted in large spaces between th e plate segments, and in addition the intracranial pressure was kept low by a V-P shunt, thus rendering the patient more vulnerable to atmospheric pre ssure.