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The aim of the current study was to investigate the operation skills and complications associated with skull defect repair using biomimetic bone (nano-hap/collagen composites). Clinical data from 45 patients with skull defects who underwent cranioplasty with biomimetic bone from January 2014 to January 2017 were retrospectively analyzed. All patients participated in follow-up visits from 8 months to 3 years postoperatively. Cranioplasties were successful in all 45 patients, but 17 patients (20 cases) presented various complications, including subcutaneous hydrops (14 cases), biomimetic bone fixation loosening (4 cases), wound indolence (1 case), and biomimetic bone fragmentation (1 case). Cranioplasty complications in surgeries using biomimetic bone are more common in children than in adults. Understanding the physicochemical properties of biomimetic bone and the normal developmental process in children, as well as mastering the appropriate surgical skills and implementing the effective preventive measures are all ways to reduce and control the incidence of complications associated with biomimetic bone cranioplasty.

To evaluate the clinical results of repairing skull defects with biomimetic bone (nano-hap/collagen composites, NHACs) in children. Methods: Thirteen children with skull defects were treated with NHACs in our hospital. The NHACs molded with the help of a 3D printer were used in the operations. Results: All 13 operations were successful, and patients recovered without infection. Only one patient suffered from subcutaneous hydrops post-operation. The implanted NHACs remained fixed well after 1 year, and their CT HU values raised gradually. Skull shapes of children developed normally. Recovery of neurological and cognitive function was significant. Conclusions: NHAC, chosen to repair skull defects in children, can coexist with normal skull and reduce the negative effects on growth and development. NHAC could be a good choice for children with skull defects.