Tantalum in the repair of traumatic skull defects

Abstract

scaphoid, and capitate, which has the largest. The metacarpals and the phalanges of the second to fifth digits are broadened and have hardly any cortex. There are cysts up to I cm. in diameter in the heads of the metacarpals, the bases and heads of all the phalanges, and the base of the terminal phalanx of the thumb (Fig. 49). FIG. 49.-Showing right hand with cysts in the scaphoid and capitate and affection of the 2nd to 5th metacarpals and all the phalanges. Left hand for comparison. COMMENTA typical case of polyostotic fibrous dysplasia has been described. The patient, who is 70, is the oldest recorded in the literature, and demonstrates that the disease does not shorten its victim's expectation of life, but merely causes deformities and spontaneous fractures. Both traumatic and pathological fractures have united in average time in this case. The involvement of the carpus and tarsus, and the sclerosis of the cortex and medulla of the tibia are unusual features. The only endocrine changes were the delayed breaking of his voice at 20 years of age.The patient has ostosclerosis, and it is tempting to try to establish a connexion between the two dictions. Radiographs of his temporal bones, moreover, tend to confirm this.

Late Intracranial Infection after Tantalum Cranioplasty

“…In rhe cases of Lewin er al. (14) the rate of infection was 9 %. The occurrence of pneumatocele secondary to defects of the frontal sinus is weil known .…”

“…0 1 rhe 52 plates removed, 26 (50%) had been insert ed in the front al area of the skull, and in 18 of these 26 cases, or 35 % of the tota l, the cran ial defecr involved the fro ntal sinus. Lewin et al (14) reported 130 rantalum cranioplasties in 128 parienrs in who m infecrion occurr ed in 9 cases, of which 4 were tr eated conservatively wirho ur removal of the tant alum plate. The infection occurred between seven weeks and two years and seven months after cranioplasry.…”

World War II, tantalum, and the evolution of modern cranioplasty technique

“…The authors sutured adjacent pericranium or periosteum to perforations made in the plate. 37 In some cases, they covered the plate with an additional layer of fascia lata that was sutured to surrounding pericranium. They noted that this method was often insufficient for frontal cranioplasties, likely due to the added effect of gravity.…”

“…37,42,44,56,75 Two studies reported on return to duty outcomes after tantalum cranioplasty. 44,75 The larger of the two studies (79 patients) reported that 46% of soldiers returned to duty and 54% were discharged from the military, most commonly due to neurological deficits or either clinical seizures or the presence of an epileptogenic focus on electroencephalography (EEG).…”

Titanium Cranioplasty

“…Tantalum was used after -the 1939-45 war (Woodhall and Spurling, 1947). It was shaped by a die/ counter die swaging technique or by hanmnering into a counter die (Lewin et al, 1948). Lewin and Gibson (1956) used tantalum to repair some of -the skull defeots in British soldiers injured in Korea.…”