Use of Split Thickness Cranial Bone Grafts in Surgical Treatment of Growing Skull Fractures
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- Category: Vol. 78, September 2010
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Use of Split Thickness Cranial Bone Grafts in Surgical Treatment of Growing Skull Fractures,MOHAMAD A. EL-TAYEB and TAREK A. TAREEF
Abstract
Background: Acute skull fracture can be complicated by a dural tear. This results in an expanding cystic mass with the dura and CSF resulting in the fracture diastasis. The position of the cystic swelling prevents the osteoblast from migrating and this prevents fracture healing. The continuous pulsatile CSF pressure causes resorption of adjacent bone. Trivial trauma in the history is often missed.
Objective: The aim of this retrospective study was to evaluate the role of early diagnosis and surgical repair using autologous split thickness skull grafts for cranioplasty, in the prevention of complications and improving the outcome of growing skull fractures.
Methods: Ten patients with growing skull fractures man-aged from 2005-2010. Plain skull X-Rays, CT scan of the brain including bone window, and MRI of the brain were done for all patients in the study. All cases undergone surgery with duroplasty using pericranial grafts and cranioplasty using autologous split skull grafts.
Results: 6 girls and 4 boys with a mean age of 11 months were included in this study. Postoperative follow-up wa done for all patients with a mean follow-up period of 1 year. No neurological deterioration or recurrence of cyst occurred in any in the patients of this study with good outcome.
Conclusion: All patients under the age of 3 years with linear skull fractures should be closely monitored and followed-up at monthly intervals for the development of growing skull fractures. Surgical intervention by duroplasty using pericra-nium, and cranioplasty using autologous split thickness skull grafts is recommended. Early intervention prevents progressive neurological sequelae and complications.