Murdoch University Research Repository

Welcome to the Murdoch University Research Repository

The Murdoch University Research Repository is an open access digital collection of research
created by Murdoch University staff, researchers and postgraduate students.

Learn more

Cranioplasty with custom-made titanium plates-14 years experience

Wiggins, A., Austerberry, R., Morrison, D., Ho, K.M. and Honeybul, S. (2013) Cranioplasty with custom-made titanium plates-14 years experience. Neurosurgery, 72 (2). pp. 248-256.

Link to Published Version:
*Subscription may be required


BACKGROUND: There is no consensus on which material is best suited for repair of cranial defects.

OBJECTIVE: To investigate the outcomes following custom-made titanium cranioplasty.

METHODS: The medical records for all patients who had titanium cranioplasty at 2 major neurosurgical centers in Western Australia were retrieved and analyzed for this retrospective cohort study.

RESULTS: Altogether, 127 custom-made titanium cranioplasties on 113 patients were included. Two patients had 3 titanium cranioplasties and 10 patients had 2. Infected bone flap (n = 61, 54%), either from previous craniotomy or autologous cranioplasty, and contaminated bone flap (n = 16, 14%) from the initial injury were the main reasons for requiring titanium cranioplasty. Complications attributed to titanium cranioplasty were common (n = 33, 29%), with infection being the most frequent complication (n = 18 patients, 16%). Complications were, on average, associated with an extra 7 days of hospital stay (interquartile range 2-17). The use of titanium as the material for the initial cranioplasty (P = .58), the presence of skull fracture(s) (P . .99) or scalp laceration (s) (P = .32) at the original surgery, and proven local infection before titanium cranioplasty (P = .78) were not significantly associated with an increased risk of infection. Infection was significantly more common after titanium cranioplasty for large defects (hemicraniectomy [39%] and bifrontal craniectomy [28%]) than after cranioplasty for small defects (P = .04).

CONCLUSION: Complications after using titanium plate for primary or secondary cranioplasty were common (29%) and associated with an increased length of hospital stay. Infection was a major complication (16%), and this suggested that more vigorous perioperative infection prophylaxis is needed for titanium plate cranioplasty.

Item Type: Journal Article
Publisher: Lippincott Williams and Wilkins
Copyright: © 2012 by the Congress of Neurological Surgeons.
Item Control Page Item Control Page