Objectives: For reconstruction of cranial defects in children preferably the original bone flap or autogenous bonegrafts are used. When autogenous bone is not available, an alternative has to be found.

Material and method: Non-resorbable alloplastic materials can be applied, but do not fix to the defect margins, do not grow and form a lifelong infection risk. A granular tricalciumphosphate/hydroxyapatite material (Tricos ^® ) mixed with bovine fibrinogen/thrombin (Tissucol ^® ) as binding agent, covered with an anatomically shaped, resorbable d , l lactide mesh plate (ResorbX ^® ) was used, fixed in the defect margins with d , l lactide pins (SonicWeld Rx ^® ).

Results: four patients, 12, 6, 4 and 1.5 years of age, have been treated with an excellent cosmetic and functional outcome after resp. 6, 3,1 and 2.5 years. Solid ossification seems present clinically and on X-rays. The resorbable lactide mesh plate gradually degrades in about 1.5 years and initially serves as anatomical template for the reconstruction material and as temporary protection of the underlying brain until the reconstruction material has been ossified sufficiently. Growth disturbances have not been found.

Conclusion: Reconstruction of cranial defects in children with a combination of tricalciumhosphate/hydroxyapatite granules, binded by fibrin glue and covered by a resorbable, anatomically shaped d , l lactide mesh has proven to be a good treatment option in cases where autogenous bone is not available.

Conflict of interest: None declared.