Zaccaria Laura, Tharakan Sasha Job, Altermatt Stefan
Department of Pediatric Surgery, University Children's Hospital, Berne, Switzerland.
Department of Pediatric Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zurich, Switzerland.
Childs Nerv Syst. 2017 Feb;33(2):343-348. doi: 10.1007/s00381-016-3327-4. Epub 2016 Dec 24.
The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality.
A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium).
Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result.
Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.
2010年起我院开始使用羟基磷灰石陶瓷（HAC）植入物治疗小儿颅骨缺损。陶瓷植入物有助于成骨细胞迁移，从而优化与宿主骨的骨整合。本研究旨在报告单中心采用这种治疗方式的经验。
对2010年7月至2014年6月期间在单一机构接受使用羟基磷灰石陶瓷植入物进行颅骨成形术的所有患者进行回顾性研究。回顾了颅骨成形术的指征、住院过程及随访情况。采用亨氏单位（HU）测量骨密度，并使用Mimics软件（Mimics创新套件v17.0医学版，Materialize公司，比利时鲁汶）计算骨整合情况。
在这4年期间，6例患者符合研究标准。其中5例患者骨整合率接近100%。1例患者骨整合不完全，骨与植入物的总接触面积为69%。平均骨密度为2800 HU（2300 - 3000 HU）。根据身体部位和骨质不同，仅骨密度估计亨氏值在400至2000 HU之间。未出现重大并发症，患者对美观效果高度满意。
对于不同适应证，小儿颅骨成形术使用羟基磷灰石陶瓷植入物是一个不错的选择。该植入物显示出优异的骨整合和美观效果。
