Thinning of Calvarial Bone by Skull Growth in a Pediatric Patient After Skull Grinding Injury

pa.ythelady61 shared this article with you from Inoreader Thinning of Calvarial Bone by Skull Growth in a Pediatric Patient After Skull Grinding Injury Via Journal of Craniofacial Surgery - Published Ahead-of-Print Several treatment options have been suggested for the treatment of scalp defects that occur following head trauma. Growth changes should be considered, especially for children. The authors report a case of delayed cranial bone absorption after successful free latissimus dorsi flap coverage following skull grinding injury in a pediatric patient. A 3-year-old patient was referred to the reconstructive surgery department because of a 7 × 8 cm-sized scalp defect in the temporoparietal area due to dragging and grinding injury. Debridement and free latissimus dorsi musculocutaneous flap coverage with split-thickness skin graft were performed. The operation was successful and antibiotics were administered for 4 weeks to prevent the occurrence of osteomyelitis (OM). The patient was discharged after confirming the absence of OM via magnetic resonance imaging. Thinning of cranial bone was observed in the skull series taken one year postoperatively. The size gradually increased, but no significant changes in size occurred after 5 years of patient's age. Magnetic resonance imaging was performed used to confirm the occurrence of OM and no specific findings were observed. It is well-known fact that the cranium grows to 90% of its adult capacity by the age of 5. In this regard, we believe that the current case and the demonstrated cranial thinning is due to bone absorption associated with the growth. In the pediatric population, injuries involving the cranial vault should be considered in the context of bone resorption due to skull growth, which may lead to cranial bone thinning. Reconstructive surgeons should closely observe the presence or absence of skull defects through long-term follow-ups. Address correspondence and reprint requests to Jun Yong Lee, MD, PhD, Department of Plastic and Reconstructive Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon 21431, Republic of Korea; E-mail: ps.jylee@catholic.ac.kr Received 22 September, 2020 Accepted 12 October, 2020 The authors report no conflicts of interest. © 2020 by Mutaz B. Habal, MD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.