Individual replacement of the frontal bone defect: case report

The objective of the skeletal defects reconstruction using individual implants is an attempt to replace lost and damaged anatomical bone structures, renew their original function, and at the same time, to restore the original aesthetic visual aspect. This work is focused on a demonstration of the design methods, fabrication and surgical techniques of the custom-made replacement of a large defect of the frontal bone on the skull. The patient was a 30-year-old woman with a defect of the frontal bone in the size of 7 x 3 x 2 cm after a serious polytrauma. The size and character of the defect excluded the use of commonly supplied augmentations. The geometry of the individual replacement was designed on the basis of a 3D model of the defect obtained from a series of CT scans. After verification of the shape accuracy of the defect made from plastic on a 3D printer, the individual replacement was fabricated from an ultra high molecular weight polyethylene (UHMWPE) by machining with the use of the CNC technology. The success of the augmentation depends on the accurate and precise fabrication of the individual replacement, which is highly demanding on the used advanced technologies.