title: Onlay frontal cranioplasty using wire reinforced methyl methacrylate.
abstract: BACKGROUND
  Methyl methacrylate is a biologically inert alloplastic material that is commonly used to rebuild the calvarial vault. Since methyl methacrylate does not permit tissue incorporation it is susceptible to displacement and/or fracture. In order to increase the tensile strength of methyl methacrylate onlay cranioplasties, we use wire reinforced masonry techniques.
  
  
  METHODS
  A 56-year-old female presents with forehead asymmetry due to displacement and fracture of a silicone alloplastic implant. This patient, treated with onlay wire reinforced methyl methacrylate, demonstrates the utility of this novel technique.
  
  
  RESULTS
  Wire is passed through 2-mm outer cortex tunnels like spokes on a wheel, around the perimeter of the defect to form a rebar grid. Methyl methacrylate is poured onto the rebar grid and contoured after it solidifies.
  
  
  CONCLUSIONS
  Wire reinforced methyl methacrylate is a simple technique to improve the tensile strength of calvarial alloplastic reconstructions.
authors.affiliation: Division of Plastic Surgery, Children's Hospital Boston, Harvard Medical School Boston, MA 02445, USA.
authors.forename: Arin K
authors.initials: AK
authors.lastname: Greene
authors.affiliation: The Institute of Reconstructive Plastic Surgery, New York University School of Medicine, 560 First Avenue, TCH-169, New York, NY 10016-6497, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Warren
authors.affiliation: The Institute of Reconstructive Plastic Surgery, New York University School of Medicine, 560 First Avenue, TCH-169, New York, NY 10016-6497, USA. Electronic address: joseph.mccarthy@med.nyu.edu.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: McCarthy
mesh_terms: D018786:Bone Substitutes; D001864:Bone Wires; D005146:Facial Asymmetry / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000601:surgery; D005624:Frontal Bone / Q000601:surgery*; D006801:Humans; D008768:Methylmethacrylates; D008875:Middle Aged; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000379:methods*; D012828:Silicones
chemical_list: D018786:Bone Substitutes; D008768:Methylmethacrylates; D012828:Silicones