Cranioplasty using cadaveric bone graft for “Growing skull fracture” and Ten- year follow up.

Sangle R P, Varun Nivargi V

Sangle R P, Varun Nivargi V

Keywords: Growing Skull Fracture in pediatric head injury, Reconstructive- cranioplastyusing cadaveric skull bone

Abstract

Growing skull fracture (GSF), a delayed cranio-cerebral complication resulting from linear skull fracture with dural tear. Damaging effects on the developing skull and brain are significant. Dur-al tear results in leptomeningeal cyst formationwhich if left untreated progressively induces local resorption of skull bone resulting in GSF. It damages the progressively-developing brain. Various materials are available for cranioplasty. It is directed at protecting dura and brain. Ca-daveric bone is the most biological, physiologically suitable material available.It may have im-mediate effect on stopping skull-bone resorption. In our knowledge this is the one of the initial cases of reconstructive-cranioplasty using cadaveric skull bone in GSF. Its effects followed up with 10-years clinical & radiological studies. It is used with the intention of studying 1) host’s ability to regenerate skull bone after cadaveric bone grafting and 2) short term & long term effects of bone grafting in paediatric age group.

References

1. Sanan, Abhay MD; Haines, Stephen J. MD; Neurosurgery: March 1997 - Volume 40 - Issue 3 - pp 588-603
2. Lende RA, Erickson TC: Growing skull fractures of childhood. J Neurosurg 18:479–489, 1961
3. Ramamurthi B, Kalyanaraman S: Rationale for surgery in growing fractures of the skull. J Neurosurg 32:427–430, 1970
4. Howship J: Practical Observations in Surgery, and Morbid Anatomy. London: A. Strahan, 1816
5. Arseni C, Ciurea AV: Clinicotherapeutic aspects in the growing skull fracture A review of the literature. Childs Brain 8: 161–172, 1981
6. Muhonen MG, Piper JG, Menezes AH: Pathogenesis and treatment of growing skull fractures. Surg Neurol 43:367–373, 1995 .
7. Goldstein F, Sakoda T, Kepes JJ, et al: Enlarging skull fractures: an experimental study. J Neurosurg 27:541–550, 1967
8. Goldstein FP, Rosenthal SA, Garancis JC, et al: Varieties of growing skull fractures in child-hood. J Neurosurg 33:25–28, 1970
9. Tandon PN, Banerji AK, Bhatia R, et al: Cranio-cerebral erosion (growing fracture of the skull in children).Part II.Clinical and radiological observations. Acta Neurochir (Wien) 88:1–9,1987
10. Kingsley D, Till K, Hoare R: Growing fractures of the skull. J Neurol Neurosurg Psychiatry 41:312–318, 1978.
11. Johnson DL, Helman T: Enlarging skull fractures in children. Childs Nerv Syst 11:265–268, 1995
12. Kutlay M, Demircan N, Akin ON, et al : Untreated growing cranial fractures detected in late stage. Neurosurgery 43:72–77, 1998
13. Urist MR.Bone: formation by autoinduction.science 1965; 150:893-9
14. Cunnigham NS, Jenkins NA, Gilbert DJ, et al. Growth/Differentiationfactor10: a new mem-ber of the transforming groth factor-B superfamily related to bone morphogenic protein-3 Growth Factors 1995; 12:99-109.
15. Boden SD, SchimandleJH, Hutton wc.Evaluation of a bovine derived osteoinductive bone proteinin a non human primate model of lumbar spine fusion. Trans Orthop Res Soc 1996; 21:118
16. Yasko Aw, Lane JM, Fellinger EJ, et al .The healing of segmental bone defects induced by recombinant human bone morphogenic protein (rhBMP-2); a radiographic, histological and biomechanical study in rats. J Bone Joint surg Am 1992;74A:659-70
17. Paramore CG, Lauryssen C, rauzzunoMJ, et al . The safety of OP-1 for lumbar fusion with decompression: a canine study. Neurosurgery 1999; 1151-5
18. Meyer RA Jr,Gruber HE,Howard BA, et al. Safety of recombinant human morphogenic pro-tein-2after spinal laminectomy in the dog . Spine 1999; 24:747-54
19. Zlotolow DA,Vaccaro AR,Salamon ML, et al. The role of bone morphogenetic proteins in spinal fusions. J.Am Acad Ortop Surg 2000:8:3-9