Split-thickness calvarial grafts in young children

Sixteen patients (mean age, 1.9 years) underwent split-thickness calvarial bone grafting using a full-thickness craniotomy, high-speed drill, and osteotomes for bone harvesting. The minimal calvarial bone thickness for a successful graft was found to be 7 mm. All patients were diagnostically studied preoperatively with computed tomographic scans and skull films. The mean follow-up was 2.9 years (range, 0.75-7.9 years). All patients had successful graft take. There were no infections or mortalities. Continued graft growth was seen in all patients. There was one dural tear during harvesting with no cerebrospinal fluid leak or postoperative sequelae. This analysis indicates that split-thickness calvarial grafts can be safely and adequately performed in children as young as 13 months of age.