Introduction: In infants, calvarial defects are generally repaired with autologous grafts. However, with large defects, these techniques can be associated with complications such as bone graft resorption, loss of blood, or local infection. Alternative materials are available for cranioplasty including metals or acrylic.
Case report: We report the case of a 3.2kg boy who had a traumatic vaginal delivery and developed a growing skull fracture resulting in a large cranial defect (50cm(2)). We describe a specific technique of cranioplasty by interposing a titanium plate between the duroplasty and bone elements, without fixation, with autologous bone fragments deposited over the mesh. Long-term follow-up was satisfactory.
Conclusion: For large skull defects in infants, the technique described affords protection to the intracranial components, induces osteogenesis in a growing cranial skeleton, and provides satisfactory aesthetic results.