Zhang R, Gao Z, Zhu YJ, Wang XF, Wang G, He JP. Spontaneous fracture of a titanium mesh cranioplasty implant in a child: A case report. World J Clin Cases 2023; 11(7): 1593-1599 [PMID: 36926410 DOI: 10.12998/wjcc.v11.i7.1593]
Corresponding Author of This Article
Jun-Ping He, MD, PhD, Chief Doctor, Department of Neurosurgery, Nanjing Children's Hospital, Nanjing Medical University, No. 8 Jiangzhongnan Road, Nanjing 21000, Jiangsu Province, China. hejunping359@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2023; 11(7): 1593-1599 Published online Mar 6, 2023. doi: 10.12998/wjcc.v11.i7.1593
Spontaneous fracture of a titanium mesh cranioplasty implant in a child: A case report
Rui Zhang, Zhe Gao, Yong-Jie Zhu, Xin-Fa Wang, Gang Wang, Jun-Ping He
Rui Zhang, Zhe Gao, Yong-Jie Zhu, Xin-Fa Wang, Gang Wang, Jun-Ping He, Department of Neurosurgery, Nanjing Children's Hospital, Nanjing Medical University, Nanjing 21000, Jiangsu Province, China
Author contributions: He JP and Wang G contributed to the conception and design; Gao Z, Zhu YJ and Wang XF contributed to the acquisition of data; Zhang R drafted the article; All authors critically revised the article and reviewed submitted version of manuscript; He JP approved the final version of the manuscript on behalf of all authors.
Supported bythe National Natural Science Foundation of China, No. 81602212; Natural Science Foundation of Jiangsu Province, No. BK20161119; Key Project supported by Medical Science and Technique Development Foundation No. YKK15139; and Nanjing Medical Science and Technique Development Foundation No. QRX17167.
Informed consent statement: Written informed consent was obtained from the patient’s parents for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Ping He, MD, PhD, Chief Doctor, Department of Neurosurgery, Nanjing Children's Hospital, Nanjing Medical University, No. 8 Jiangzhongnan Road, Nanjing 21000, Jiangsu Province, China. hejunping359@163.com
Received: November 17, 2022 Peer-review started: November 17, 2022 First decision: January 3, 2023 Revised: January 15, 2023 Accepted: February 13, 2023 Article in press: February 13, 2023 Published online: March 6, 2023 Processing time: 105 Days and 9.7 Hours
Abstract
BACKGROUND
Titanium mesh cranioplasty is often performed after decompressive craniectomy. Spontaneous fracture of the titanium prosthesis is an extremely rare postoperative complication. Here, we report a 10-year-old boy who presented with a spontaneous fracture of titanium mesh without antecedent head trauma.
CASE SUMMARY
A 10-year-old boy presented with a 1-wk history of a tender bulge over the left temporo-parieto-occipital scalp. He had undergone a temporo-parieto-occipital titanium mesh cranioplasty 26 mo previously. He denied antecedent head trauma. Computerized tomography disclosed a perpendicular fissure in the titanium mesh, suggesting a diagnosis of spontaneous titanium mesh fracture. He underwent a second temporo-parieto-occipital cranioplasty and made an uneventful recovery. Three-dimensional modeling and finite element analyses were used to explore potential risk factors of titanium mesh fracture.
CONCLUSION
We report a case of spontaneous fracture of a titanium mesh cranioplasty implant. The current case and literature review indicate that titanium mesh implants should be well-anchored to the base of bony defects to prevent fatigue-induced fractures.
Core Tip: Titanium mesh cranioplasty is often indicated after decompressive craniectomy. We present a rare case of a spontaneous fracture of a titanium mesh cranioplasty implant in a 10-year-old boy. By conducting a literature review and finite element analysis, we learned that titanium mesh prosthetic implants should be well-anchored to the base of bony defects to prevent fatigue-induced fractures.
