Intermediate repair (7 weeks) of an isolated anterior frontal bone fracture using re-osteotomy and cranial mesh: a case report

Frontal bone fractures result from high velocity trauma, and account for 5–15% of craniomaxillofacial fractures. They may involve the anterior and/or posterior table and frontal sinus outflow tract and are frequently associated with concurrent panfacial or intracranial injuries, requiring multidisciplinary input. Surgery is usually immediate and focuses on restoring facial contour, protecting intracranial structures and avoiding complications. The management of frontal bone fractures remains controversial there is currently no strong consensus on preferred techniques nor specific recommendations of timings. We present a case of a severely comminuted fracture of the anterior wall of the frontal bone, which underwent intermediate repair at 7 weeks with re-osteotomy and cranial mesh fixation via coronal approach. This surgical approach provided excellent aesthetic reconstruction, minimal bleeding and rapid post-operative recovery with no complications observed at 6-month follow-up. There were advantages for both the patient and the surgeon, demonstrating the potential of intermediate repair with mesh fixation in appropriately selected cases. This case highlights an effective management strategy for complex anterior frontal bone fractures, supporting the use of intermediate surgical repair in achieving favourable results and minimising adverse effects.