Objective: A decompressive hemicraniectomy is a potentially life-saving intervention following head trauma. Once performed patients are obliged to undergo a second procedure with cranioplasty. Two of themost commonlyusedmaterials are autologousbone andpolymethylmethacrylate (PMMA).We have now evaluated complications following a cranioplasty using these materials.
Materials and methods: During a 7-year period (2002–2008) 49 patients were operated with a decompressive craniectomy following head trauma. Patients received a cranioplasty consisting of autologous bone (30 patients, 61.2%) or PMMA (19 patients, 38.8%) and were followed at least 24 months. Patient data were collected retrospectively.
Results: Twenty patients (20/49, 40.8%) experienced a complication that prompted a re-operation. There was a signiﬁcantly higher rate of complications leading to a re-operation (53.3% vs. 21.1%, p=0.03) and a shorter survival time of the cranioplasty (mean 48.1±7.8 vs. 79.5±9.0 months, p=0.035) in patients with autologous bone compared to PMMA. Bone resorption and the presence of postoperative hematomas were signiﬁcantly more common in patients with autologous bone. The material used for cranioplasty was the only variable that signiﬁcantly correlated to the rate of complications.
Conclusions:In our series we had a high percentage of patients needing re-operation due to complications following a cranioplasty. Though generally considered a straightforward procedure, complications and associated morbidity in patients undergoing cranioplasty should not be underestimated
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