Split-Rib Cranioplasty Using a Patient-Specific Three-Dimensional Printing Model

The reconstruction of cranial bone defects is necessary not just for the protection of the brain, but also for aesthetics. Cranial bone reconstruction may be conducted using autologous or synthetic bone tissue [1]. When synthetic bone is utilized, the reconstruction of large defects is possible, and problems with the donor area are eliminated. However, other possible problems include allergic reaction, infection, and implant exposure [2]. The reconstruction of cranial bone defects using autologous bone tissue has the advantages of avoiding both allergic reaction and implant exposure, but potential problems include donor site morbidity, prolonged surgical time, unpredictable resorption, and asymmetrical bone shape [3,4]. The advantages and disadvantages of these two methods complement each other. With the development of three-dimensional printing (3D printing) technology, the prefabrication of patient-specific implants is now helping to achieve a symmetrical cranial shape, and minimize tissue damage [5]. While surgical methods utilizing the latest in 3D printing technology have proven to be a great help in producing alloplastic material for cranioplasty, to the author's knowledge, there have been no reports of surgery using 3D printing for methods of grafting autologous bone tissue. Accordingly, by conducting autologous cranioplasty using 3D printing, the authors obtained favorable results both functionally and aesthetically, which are presented here. A sixteen-year-old patient who had suffered cerebral hemorrhage after being injured in a traffic accident underwent a two-stage extensive decompressive craniectomy. One area was reconstructed using preserved bone fragments, but in another area, in which the bone fragments had not been preserved, a 14 cm × 12 cm skull defect remained (Fig. 1). Considering the fact that the patient was very active and was comparatively young,