Cerebral Parenchymal Probe Placement with Extreme Limitation of Cranial Bone

AbstractThis study aimed to define better the clinical presentation, fracture patterns, and features predictive of associated injuries and need for surgery in pediatric facial trauma patients in an urban setting. Charts of patients 18 years or younger with International Classification of Disease 9th and 10th revision (ICD-9/ICD-10) codes specific for facial fractures (excluding isolated nasal fractures) at NY-Presbyterian/Weill Cornell Medical Center between 2008 and 2017 were retrospectively reviewed. Of 204 patients, most were referred to the emergency department by a physician's office or self-presented. Children (age 0–6 years) were most likely to have been injured by falls, while more patients 7 to 12 years and 13 to 18 years were injured during sporting activities (p < 0.0001). Roughly half (50.5%) of the patients had a single fracture, and the likelihood of surgery increased with greater numbers of fractures. Older patients with either orbital or mandibular fractures were more likely to undergo surgery than younger ones (p = 0.0048 and p = 0.0053, respectively). Cranial bone fractures, CSF leaks, and intracranial injuries were more common in younger patients (p < 0.0001) than older patients and were more likely after high energy injuries; however, 16.2% of patients sustaining low energy injuries also sustained cranial bone, CSF leak, or intracranial injury. In an urban environment, significant pediatric facial fractures and associated injuries may occur after nonclassic low kinetic energy traumatic events. The age of the patient impacts both the injuries sustained and the treatment rendered. It is essential to maintain a high index of suspicion for associated injuries in all pediatric facial trauma patients.

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Biomimetic reduced graphene oxide coated collagen scaffold for in situ bone regeneration

Scientific Reports ◽

10.1038/s41598-021-96271-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sajad Bahrami ◽

Nafiseh Baheiraei ◽

Mostafa Shahrezaee

Keyword(s):

Graphene Oxide ◽

Reduced Graphene Oxide ◽

Cranial Bone ◽

Drying Methods ◽

Porous Scaffolds ◽

Alizarin Red ◽

Reduced Graphene ◽

Coated Collagen

AbstractA variety of bone-related diseases and injures and limitations of traditional regeneration methods require new tissue substitutes. Tissue engineering and regeneration combined with nanomedicine can provide different natural or synthetic and combined scaffolds with bone mimicking properties for implantation in the injured area. In this study, we synthesized collagen (Col) and reduced graphene oxide coated collagen (Col-rGO) scaffolds, and we evaluated their in vitro and in vivo effects on bone tissue repair. Col and Col-rGO scaffolds were synthesized by chemical crosslinking and freeze-drying methods. The surface topography, and the mechanical and chemical properties of scaffolds were characterized, showing three-dimensional (3D) porous scaffolds and successful coating of rGO on Col. The rGO coating enhanced the mechanical strength of Col-rGO scaffolds to a greater extent than Col scaffolds by 2.8 times. Furthermore, Col-rGO scaffolds confirmed that graphene addition induced no cytotoxic effects and enhanced the viability and proliferation of human bone marrow-derived mesenchymal stem cells (hBMSCs) with 3D adherence and expansion. Finally, scaffold implantation into rabbit cranial bone defects for 12 weeks showed increased bone formation, confirmed by Hematoxylin–Eosin (H&E) and alizarin red staining. Overall, the study showed that rGO coating improves Col scaffold properties and could be a promising implant for bone injuries.

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Quantitative Assessment of Shape Deformation of Regional Cranial Bone for Evaluation of Surgical Effect in Patients with Craniosynostosis

Applied Sciences ◽

10.3390/app11030990 ◽

2021 ◽

Vol 11 (3) ◽

pp. 990

Author(s):

Min Jin Lee ◽

Helen Hong ◽

Kyu Won Shim

Keyword(s):

Quantitative Assessment ◽

Deformable Registration ◽

Occipital Bone ◽

Cranial Bone ◽

Shape Deformation ◽

Surface Model ◽

Cephalic Index ◽

Skull Shape ◽

Quantification Method ◽

Parietal Bones

Surgery in patients with craniosynostosis is a common treatment to correct the deformed skull shape, and it is necessary to verify the surgical effect of correction on the regional cranial bone. We propose a quantification method for evaluating surgical effects on regional cranial bones by comparing preoperative and postoperative skull shapes. To divide preoperative and postoperative skulls into two frontal bones, two parietal bones, and the occipital bone, and to estimate the shape deformation of regional cranial bones between the preoperative and postoperative skulls, an age-matched mean-normal skull surface model already divided into five bones is deformed into a preoperative skull, and a deformed mean-normal skull surface model is redeformed into a postoperative skull. To quantify the degree of the expansion and reduction of regional cranial bones after surgery, expansion and reduction indices of the five cranial bones are calculated using the deformable registration as deformation information. The proposed quantification method overcomes the quantification difficulty when using the traditional cephalic index(CI) by analyzing regional cranial bones and provides useful information for quantifying the surgical effects of craniosynostosis patients with symmetric and asymmetric deformities.

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Design of 3D Additively Manufactured Hybrid Structures for Cranioplasty

Materials ◽

10.3390/ma14010181 ◽

2021 ◽

Vol 14 (1) ◽

pp. 181

Author(s):

Roberto De Santis ◽

Teresa Russo ◽

Julietta V. Rau ◽

Ida Papallo ◽

Massimo Martorelli ◽

...

Keyword(s):

Physical Models ◽

Cranial Bone ◽

Head Model ◽

Rigid Sphere ◽

Element Analysis ◽

Aliphatic Polyesters ◽

Hybrid Device ◽

Wide Range ◽

Hybrid Devices ◽

Technical Solutions

A wide range of materials has been considered to repair cranial defects. In the field of cranioplasty, poly(methyl methacrylate) (PMMA)-based bone cements and modifications through the inclusion of copper doped tricalcium phosphate (Cu-TCP) particles have been already investigated. On the other hand, aliphatic polyesters such as poly(ε-caprolactone) (PCL) and polylactic acid (PLA) have been frequently investigated to make scaffolds for cranial bone regeneration. Accordingly, the aim of the current research was to design and fabricate customized hybrid devices for the repair of large cranial defects integrating the reverse engineering approach with additive manufacturing, The hybrid device consisted of a 3D additive manufactured polyester porous structures infiltrated with PMMA/Cu-TCP (97.5/2.5 w/w) bone cement. Temperature profiles were first evaluated for 3D hybrid devices (PCL/PMMA, PLA/PMMA, PCL/PMMA/Cu-TCP and PLA/PMMA/Cu-TCP). Peak temperatures recorded for hybrid PCL/PMMA and PCL/PMMA/Cu-TCP were significantly lower than those found for the PLA-based ones. Virtual and physical models of customized devices for large cranial defect were developed to assess the feasibility of the proposed technical solutions. A theoretical analysis was preliminarily performed on the entire head model trying to simulate severe impact conditions for people with the customized hybrid device (PCL/PMMA/Cu-TCP) (i.e., a rigid sphere impacting the implant region of the head). Results from finite element analysis (FEA) provided information on the different components of the model.

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