Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2023; 11(7): 1593-1599
Published online Mar 6, 2023. doi: 10.12998/wjcc.v11.i7.1593
Spontaneous fracture of a titanium mesh cranioplasty implant in a child: A case report
Rui Zhang, Zhe Gao, Yong-Jie Zhu, Xin-Fa Wang, Gang Wang, Jun-Ping He
Rui Zhang, Zhe Gao, Yong-Jie Zhu, Xin-Fa Wang, Gang Wang, Jun-Ping He, Department of Neurosurgery, Nanjing Children's Hospital, Nanjing Medical University, Nanjing 21000, Jiangsu Province, China
Author contributions: He JP and Wang G contributed to the conception and design; Gao Z, Zhu YJ and Wang XF contributed to the acquisition of data; Zhang R drafted the article; All authors critically revised the article and reviewed submitted version of manuscript; He JP approved the final version of the manuscript on behalf of all authors.
Supported by the National Natural Science Foundation of China, No. 81602212; Natural Science Foundation of Jiangsu Province, No. BK20161119; Key Project supported by Medical Science and Technique Development Foundation No. YKK15139; and Nanjing Medical Science and Technique Development Foundation No. QRX17167.
Informed consent statement: Written informed consent was obtained from the patient’s parents for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Ping He, MD, PhD, Chief Doctor, Department of Neurosurgery, Nanjing Children's Hospital, Nanjing Medical University, No. 8 Jiangzhongnan Road, Nanjing 21000, Jiangsu Province, China. hejunping359@163.com
Received: November 17, 2022
Peer-review started: November 17, 2022
First decision: January 3, 2023
Revised: January 15, 2023
Accepted: February 13, 2023
Article in press: February 13, 2023
Published online: March 6, 2023
Abstract
BACKGROUND

Titanium mesh cranioplasty is often performed after decompressive craniectomy. Spontaneous fracture of the titanium prosthesis is an extremely rare postoperative complication. Here, we report a 10-year-old boy who presented with a spontaneous fracture of titanium mesh without antecedent head trauma.

CASE SUMMARY

A 10-year-old boy presented with a 1-wk history of a tender bulge over the left temporo-parieto-occipital scalp. He had undergone a temporo-parieto-occipital titanium mesh cranioplasty 26 mo previously. He denied antecedent head trauma. Computerized tomography disclosed a perpendicular fissure in the titanium mesh, suggesting a diagnosis of spontaneous titanium mesh fracture. He underwent a second temporo-parieto-occipital cranioplasty and made an uneventful recovery. Three-dimensional modeling and finite element analyses were used to explore potential risk factors of titanium mesh fracture.

CONCLUSION

We report a case of spontaneous fracture of a titanium mesh cranioplasty implant. The current case and literature review indicate that titanium mesh implants should be well-anchored to the base of bony defects to prevent fatigue-induced fractures.

Keywords: Cranioplasty, Prosthesis fracture, Spontaneous fracture, Titanium, Case report

Core Tip: Titanium mesh cranioplasty is often indicated after decompressive craniectomy. We present a rare case of a spontaneous fracture of a titanium mesh cranioplasty implant in a 10-year-old boy. By conducting a literature review and finite element analysis, we learned that titanium mesh prosthetic implants should be well-anchored to the base of bony defects to prevent fatigue-induced fractures.