Secondary reconstruction of cranial defects.

The increase in the number of cranial defects following injury requires more extensive use of plastic reconstructive measures on account of the exposed site of the defects or for cosmetic reasons. In 30 cases of secondary cranial defects, we have used various means of reconstruction. Alloplastic materials are used in our patients only to a limited degree, autologous bone transplants are preferentially employed. Of the autoplastics, secondary calvarium reimplantation has been the most successful, with respect both to function and cosmetic results. Our experience shows that split-rib grafts are also very suitable for the closure of defects, while sliding bone grafts with a periosteal pedicle are rarely indicated. The selection of the transplant material in the individual case and our experience with various methods are discussed.