title: Use of the "mortise and tenon" principle in the augmentation of autologous cranioplasty using bone cement in a child.
abstract: We report the case of a 20-month-old boy with autologous bone graft resorption that resulted in a floating bone graft and progressive asymmetric deformity of the skull. The patient had undergone decompressive craniectomy for acute subdural hematoma at the age of 13 months after a fall, followed by cranioplasty 1 month later with an autologous bone graft, which was stored in a freezer immediately after surgery. We used the mortise and tenon principle to replace the screws and plates to join a polymethylmethacrylate prosthesis to the skull, augmenting the resorbed autologous bone graft. The cosmetic effect was maintained and craniocerebral protection was restored. It is thought that this technique could be used for bone defects of various sizes in patients of any age in cases where screws and plates are not suitable.
authors.affiliation: Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Chien-Hsun
authors.initials: CH
authors.lastname: Li
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Yang
authors.forename: Huei-Shyong
authors.initials: HS
authors.lastname: Wang
authors.forename: Yong-Kwang
authors.initials: YK
authors.lastname: Tu
authors.forename: Meng-Fai
authors.initials: MF
authors.lastname: Kuo
mesh_terms: D000058:Accidental Falls; D001843:Bone Cements; D003399:Craniotomy / Q000379:methods*; D020199:Hematoma, Subdural, Acute / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D012886:Skull / Q000601:surgery*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate