Classification of autogenous skull grafts in cranial reconstruction

Although the literature provides a general description of various techniques of reconstruction of the cranium with autogenous bone grafts, no classification exists outlining the options in an orderly fashion. A classification of autogenous skull grafts in cranial reconstruction is hereby presented. These grafts include bone dust, shave, sliding, transpositional, full-thickness split, and vascularized pedicle. The uses of each graft and its advantages and disadvantages are discussed. The location of the defect, the size, and the thickness of the skull are variables that must be considered in utilizing these grafts. Often a combination of grafts is required to provide the best cranial contour. Understanding the characteristics of these types of grafts provides the surgeon with the versatility necessary in reconstructing cranial defects.