Cranioplasty in children.

In children, acquired skull defects often close spontaneously. This is most likely to take place when the dura mater and the pericranium are intact. Congenital skull defects rarely close spontaneously. Cranioplasty will be needed when a bone defect has failed to close or when it is unlikely to do so. Various methods are available: autogenous bone, acrylic resin, and metal prostheses have been widely used. A series of 68 operations performed on children under the age of 15 years is reviewed. It is concluded that shaped titanium plates are usually preferable. These can be formed by hand, or in a pressure chamber; simple defects can be closed with ready-made titanium strips. Fixation by screws is recommended. Titanium plates have been used successfully even in very young children.