PMC5799974_01
Preoperative photographs showing left cranial bone defect (frontal view)
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F1
He was referred from the Department of Neurosurgery, Medical College for rehabilitation of postsurgical defect on the left side of the head caused from firework tragedy [Figures 1-3].
Preoperative photographs (lateral view)
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F2
He was referred from the Department of Neurosurgery, Medical College for rehabilitation of postsurgical defect on the left side of the head caused from firework tragedy [Figures 1-3].
Computed tomography with skull defect
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F3
He was referred from the Department of Neurosurgery, Medical College for rehabilitation of postsurgical defect on the left side of the head caused from firework tragedy [Figures 1-3].
Impression of the defect
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F4
After setting, 2-3 layers of quick setting plaster was poured to achieve a firm base [Figure 4], and the impression was removed and poured in dental stone (kalstone) [Figure 5].
Retrieved cast
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F5
After setting, 2-3 layers of quick setting plaster was poured to achieve a firm base [Figure 4], and the impression was removed and poured in dental stone (kalstone) [Figure 5].
Wax pattern of the defect
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F6
Molten wax was poured into the defect for the fabrication of a wax pattern, and it was carved out from inside to simulate the thickness of the bone [Figure 6].
Extracranial tryin of titanium plate
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F7
In the titanium implant, 2-mm holes were drilled with same drill bits throughout the plate as per the instructions of neurosurgeon and were tried extracranially [Figure 7].
Neurosurgical procedure
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F8
Peroperative, after reflection of flap [Figure 8] and exposure of the bony defect, the implant was made to seat in the defect properly [Figure 9].
Neurosurgical procedure showing titanium implant in position
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F9
Peroperative, after reflection of flap [Figure 8] and exposure of the bony defect, the implant was made to seat in the defect properly [Figure 9].
Sutures placed
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F10
The screws were tightened into the holes to secure implant into position, and the flap was sutured back into position [Figure 10].
Postoperative view showing excellent adaptation and symmetry
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F11
The reestablished cranial contour was well appreciated during follow-up [Figures 11 and 12].
Postoperative aerial view
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F12
The reestablished cranial contour was well appreciated during follow-up [Figures 11 and 12].