{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:27:34Z","timestamp":1760059654603,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/reports8030102","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T11:15:23Z","timestamp":1750936523000},"page":"102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Reconstruction of Extended Multifragmented Skull Fracture: Case Report and Technical Note"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5708-9462","authenticated-orcid":false,"given":"Iv\u00e1n N.","family":"Camal Ruggieri","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, General Hospital Bamberg, 96049 Bamberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guenther C.","family":"Feigl","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital Bamberg, 96049 Bamberg, Germany"},{"name":"Department of Neurosurgery, University Hospital Tuebingen, 72016 Tuebingen, Germany"},{"name":"Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin W.","family":"Britz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4458-1375","authenticated-orcid":false,"given":"Dzmitry","family":"Kuzmin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital Bamberg, 96049 Bamberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5793-8436","authenticated-orcid":false,"given":"Daniel","family":"Staribacher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital Bamberg, 96049 Bamberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/S0140-6736(12)60864-2","article-title":"Early Management of Severe Traumatic Brain Injury","volume":"380","author":"Rosenfeld","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jsr.2012.08.011","article-title":"Trends in Traumatic Brain Injury in the U.S. and the Public Health Response: 1995\u20132009","volume":"43","author":"Coronado","year":"2012","journal-title":"J. Saf. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S1474-4422(12)70262-4","article-title":"Incidence of Traumatic Brain Injury in New Zealand: A Population-Based Study","volume":"12","author":"Feigin","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s00701-008-0145-9","article-title":"Surgical Complications Secondary to Decompressive Craniectomy in Patients with a Head Injury: A Series of 108 Consecutive Cases","volume":"150","author":"Yang","year":"2008","journal-title":"Acta Neurochir."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/MCC.0b013e32807f2a94","article-title":"The Role of Surgery in Traumatic Brain Injury","volume":"13","author":"Servadei","year":"2007","journal-title":"Curr. Opin. Crit. 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Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1056\/NEJMoa1605215","article-title":"Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension","volume":"375","author":"Hutchinson","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s00774-020-01168-0","article-title":"Bone Fracture Healing: Perspectives According to Molecular Basis","volume":"39","author":"Issa","year":"2021","journal-title":"J. Bone Miner. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1097\/SCS.0b013e3181b09b9a","article-title":"Reconstruction of Skull Defects: Currently Available Materials","volume":"20","author":"Goiato","year":"2009","journal-title":"J. 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Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1227\/NEU.0b013e31827b98f3","article-title":"Cranioplasty with Custom-Made Titanium Plates-14 Years Experience","volume":"72","author":"Wiggins","year":"2013","journal-title":"Neurosurgery"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E19","DOI":"10.3171\/2014.2.FOCUS13561","article-title":"Materials Used in Cranioplasty: A History and Analysis","volume":"36","author":"Shah","year":"2014","journal-title":"Neurosurg. Focus"},{"key":"ref_17","first-page":"e39516","article-title":"Titanium Versus Autologous Bone-Based Cranioplasty: A Systematic Review and Meta-Analysis","volume":"15","author":"Kahlar","year":"2023","journal-title":"Cureus"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/3\/102\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:59:38Z","timestamp":1760032778000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/3\/102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["reports8030102"],"URL":"https:\/\/doi.org\/10.3390\/reports8030102","relation":{},"ISSN":["2571-841X"],"issn-type":[{"type":"electronic","value":"2571-841X"}],"subject":[],"published":{"date-parts":[[2025,6,26]]}}}