Demineralized bone bandeau in a patient with kleeblattschädel skull deformity

Management of complex craniofacial deformities in the neonatal setting can pose daunting reconstructive challenges due to the limited supply of autogenous bone. We present a patient who was born with idiopathic nonsyndromal pansynostosis and the associated kleeblattschädel skull deformity. In this setting the patient's initial evaluation was suggestive of raised intracranial pressure and, as such, an emergent decompression was required. The native bone was unsuitable for reconstruction. Therefore, an allogenic demineralized perforated cortical iliac bone graft was used as the cornerstone of the reconstruction. Subsequent 2-year follow-up utilizing both clinical and microscopic evaluation revealed excellent osseous integration of the demineralized bone implant with near-total transformation into living bone. This clinical success has encouraged us to increase our utilization of this bone substitute in the neonatal setting.