“Bone-mesh”: Combined fractured bone and titanium mesh for primary reconstruction of compound skull fractures

Abstract

Problem considered Skull fractures account for a large number of traumatic brain injuries and these injuries warrant urgent medical attention. Their variety in location, the magnitude of intra-cranial injuries, and a fairly cautious approach to reconstruct primarily have led to a lack in consensus in the management of these injuries. The long standing practice of removal of bone is giving way to single stage repair. The aim of the study was to analyze the benefits and adverse effects of primary reconstruction of skull using combination of the fractured fragments of bone and titanium mesh as the cranioplasty material. Methods Patients with compound fractures of skull, between the ages of 18?65years, were planned for primary reconstruction with fractured bone fragments and titanium mesh after dealing with the intra-cranial lesion. Patients were observed daily for clinical signs of infections and alternate day lab checks (WBC counts) were performed. Post-operative CT scans with 3-diamensional skull reconstruction was obtained before discharge and assessment of cosmetic results were done. Results Eleven male (mean age 32.63 ? 10.87 years) patients underwent primary reconstruction of compound skull fractures. The mean interval between injury and operation was 62.2 ? 21 h. The mean duration of surgery was 162.7 ? 32.3 min 9 had a Glasgow outcome Score (GOS) of 5, 1 had GOS 4, 1 had death, resulting from sepsis. Mean follow-up is 2.81 months and no complications could be observed within this period. Conclusion Primary reconstruction of compound fractures should be attempted in any possible case, even in ones with delayed presentation. When done with native bone fragments and titanium mesh provides cosmesis, protection, prevention of skin flap syndrome and better strength of construct. Although the rate of infection has been nil in our series, a larger series with longer follow-up is warranted before introducing into clinical practice.

Compound Depressed Fractures

“…When done with native bone fragments and titanium mesh, it results in cosmoses, protection and prevention from skin flap syndrome with improved strength of construct. 13 Repair of the frontal depressed skull fractures by refixation of bony fragments with titanium clamping is suitable and reliable. Such techniques promises to be a better substitute in the reconstruction of frontal comminuted depressed skull fractures.…”

NiTi shape memory alloy cellular meshes: manufacturing by investment casting and characterization

“…Among the devices that could benefit from the SMA's unique behaviour are metallic meshes, used, for instance, as implants acting as scaffolds for the reconstruction of bones in orthopaedics and orthodontics. Some of these potential applications are the reconstruction of critical bone defects [11], partial reconstruction of bone defects of alveolar ridges [12], and the replacement of components, such as wires or bars in orthopaedic and orthodontic treatments [12][13][14][15][16][17][18]. These mesh devices are currently manufactured with medical-grade titanium alloys.…”