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Case Report

Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note

by
Iván N. Camal Ruggieri
1,*,
Guenther C. Feigl
1,2,3,*,
Gavin W. Britz
3,
Dzmitry Kuzmin
1 and
Daniel Staribacher
1
1
Department of Neurosurgery, General Hospital Bamberg, 96049 Bamberg, Germany
2
Department of Neurosurgery, University Hospital Tuebingen, 72016 Tuebingen, Germany
3
Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, USA
*
Authors to whom correspondence should be addressed.
Reports 2025, 8(3), 102; https://doi.org/10.3390/reports8030102
Submission received: 3 May 2025 / Revised: 24 June 2025 / Accepted: 25 June 2025 / Published: 26 June 2025
(This article belongs to the Section Orthopaedics/Rehabilitation/Physical Therapy)

Abstract

Background and Clinical Significance: Traumatic brain injury (TBI) represents a major public health concern due to its profound neurological, psychological, and socioeconomic consequences. Effective management is essential to optimize patient outcomes and reduce healthcare burden. In cases involving extensive bone loss or complex fractures, particularly when decompressive craniectomy (DC) is considered, secondary cranial reconstruction is typically required. However, DC is associated with prolonged hospitalization, multiple surgical interventions, an increased risk of complications, and higher costs. Case Presentation: We present the case of a 59-year-old male involved in a high-energy bicycle accident, sustaining severe craniofacial trauma with multiple midface fractures, a multifragmented left cranial fracture, and a left-sided epidural hematoma with brain compression. Hematoma evacuation and immediate primary reconstruction of the fractured skull using autologous bone were successfully performed, avoiding the need for DC. The patient recovered under intensive care and was transferred to a neurorehabilitation center. Conclusions: Primary reconstruction of large skull fractures using autologous bone should remain the goal, whenever possible, in order to avoid additional costs, risks, and complications.
Keywords: skull; reconstruction; traumatic brain injury skull; reconstruction; traumatic brain injury

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MDPI and ACS Style

Camal Ruggieri, I.N.; Feigl, G.C.; Britz, G.W.; Kuzmin, D.; Staribacher, D. Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note. Reports 2025, 8, 102. https://doi.org/10.3390/reports8030102

AMA Style

Camal Ruggieri IN, Feigl GC, Britz GW, Kuzmin D, Staribacher D. Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note. Reports. 2025; 8(3):102. https://doi.org/10.3390/reports8030102

Chicago/Turabian Style

Camal Ruggieri, Iván N., Guenther C. Feigl, Gavin W. Britz, Dzmitry Kuzmin, and Daniel Staribacher. 2025. "Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note" Reports 8, no. 3: 102. https://doi.org/10.3390/reports8030102

APA Style

Camal Ruggieri, I. N., Feigl, G. C., Britz, G. W., Kuzmin, D., & Staribacher, D. (2025). Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note. Reports, 8(3), 102. https://doi.org/10.3390/reports8030102

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