Reconstruction of skull bone defects using the hydroxyapatite cement with calvarial split transplants.
OBJECTIVE
We sought to present a new method for primary reconstruction of traumatic or tumor calvarial defects.


METHODS
Forty-one patients underwent reconstruction of calvarial bone defects between October 1998 and December 2001. Among them were 19 patients who needed reconstruction of the calvaria due to traumatic bone loss. Five of these trauma cases had insufficient primary reconstruction of the calvaria. Tumor resection caused calvarial defects in 22 patients. For primary reconstruction of the skull bone defects, calvarial split grafts were used to cover the defect as accurately as possible. The monocortical layers of the calvaria were fixed with titanium miniplates. Irregular defects surrounding the transplanted regions were filled with hydroxyapatite cement. In one case of posttraumatic bone loss, hydroxyapatite cement alone was sufficient to reconstruct the defect.


RESULTS
The follow-up of each patient was at least 6 months; the longest period was 38 months. Evaluated clinical and radiologic results are stable, showing no measurable side effects.


CONCLUSIONS
Hydroxyapatite cement alone or in combination with calvarial split grafts gave clinically and aesthetically stable results in the reconstruction of skull bone defects. The cement can be used for many reconstruction possibilities in craniofacial surgery.
Wiltfang
Joerg
J
Department of Oral and Craniomaxillofacial Surgery, Erlangen-Nuremberg University, Erlangen-Nuremberg, Germany.
Kessler
Peter
P
Buchfelder
Michael
M
Merten
Hans-Albert
HA
Neukam
Friedrich Wilhelm
FW
Rupprecht
Stephan
S
D000328:Adult; D000368:Aged; D001843:Bone Cements; D001860:Bone Plates; D016025:Bone Transplantation; D001932:Brain Neoplasms / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D005357:Fibrous Dysplasia of Bone / Q000601:surgery; D006801:Humans; D006882:Hydroxyapatites; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012886:Skull / Q000601:surgery*; D012887:Skull Fractures / Q000601:surgery
D001843:Bone Cements; D006882:Hydroxyapatites; C475044:hydroxyapatite cement