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Cranial bone grafting in children

W J Koenig1, J M Donovan, J M Pensler

  • 1Division of Plastic Surgery, Children's Memorial Hospital, Chicago, Ill. 60614.

Plastic and Reconstructive Surgery
|January 1, 1995
PubMed
Summary
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Skull thickness and diploic space in children can be predicted by age. This study recommends split cranial bone grafting after age 3 and in situ grafting after age 9 for optimal results.

Area of Science:

  • Pediatric Radiology
  • Craniofacial Surgery
  • Orthopedic Surgery

Background:

  • Calvarial bone is frequently used for bone grafting in pediatric patients.
  • Understanding the age-related changes in cranial bone thickness and the development of the diploic space is crucial for surgical planning.

Purpose of the Study:

  • To assess the thickness of the skull and the diploic space in pediatric patients.
  • To determine the relationship between age and cranial bone characteristics relevant to bone grafting procedures.

Main Methods:

  • Computed tomographic (CT) scans of 96 patients, ranging from newborns to 21 years old, were retrospectively reviewed.
  • Measurements of parietal bone thickness and the presence/absence of a diploic space were analyzed in relation to patient age.

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Main Results:

  • Cranial bone thickness, particularly of the parietal bone, can be reliably predicted as a function of age.
  • The growth velocity of parietal bone thickness diminishes with increasing age.
  • The presence of a diploic space is also reliably predictable based on age.

Conclusions:

  • Split cranial bone grafting is recommended after the age of 3 years.
  • In situ cranial bone grafting should be considered only after the age of 9 years.
  • Age-based predictions of cranial bone thickness and diploic space aid in optimizing bone graft harvesting techniques.