Exchange Cranioplasty for Growing Skull Fracture Using a 3D Model

A bstract Introduction: Growing skull fracture is a rare complication of head injury in childhood. The predominant factor leading to growing fractures is a defect in the dura mater, and repairing the same is imperative for healing. Here, we introduce a method of exchange cranioplasty using a customized 3D skull model as a bone graft template. Result: A 2-year-old sustained a head injury at 6 months of age, following which he developed cranial swelling progressively growing with weakness of the contralateral limbs. Using a 3D template of the preexisting calvarial defect, a bone graft was harvested from the opposite side, slightly larger than the actual defect. The dura was repaired with a pericranial graft. An extra bone graft was used to fill the donor site. One year post-surgery, the donor and graft sites have grown extensively with excellent cosmetic results. Conclusion: Managing growing skull fractures might be straightforward but can often be complex regarding cosmetic results and recurrence. Here, we introduce a new surgical method for more effective and sustainable management of large defects.