Paediatric cranial defect reconstruction using bioactive fibre-reinforced composite implant: early outcomes

Piitulainen JM, Posti JP, Aitasalo KMJ, Vuorinen K, Vallittu PK, Serlo W

Eight cranioplasties were performed on seven patients, aged 2.5-16 years and having large (>16 cm2) skull bone defects. The implant used in this study was a patient- specific, glassfibre reinforced composite, which contained a bioactive glass particulate compound, S53P4. Results During follow-up (average 35.1 months), one minor complication was observed and three patients needed revision surgery. Two surgical site infections were observed.

After treatment of complications, a good functional and cosmetic out- come was observed in all patients. The implants had an onlay design and fitted the defect well. In clinical and imaging examinations, the implants were in the original position with no signs of implant migration, degradation or mechanical breakage. Conclusions Here, we found that early cranioplasty outcomes with the fibre-reinforced composite implant were promising.

However, a longer follow-up time and a larger group of patients are needed to draw firmer conclusions regarding the long-term benefits of the proposed novel biomaterial and implant design. The glassfibre reinforced composite implant incorporated by particles of bioactive glass may offer an original, non-metallic and bioactive alternative for reconstruction of large skull bone defects in a paediatric population.

DOI: 10.1007/s00701-015-2363-2