Application of 3D-printed skull protective cap in patients with traumatic skull defects

doi:10.3877/cma.j.issn.2095-9141.2026.02.007

Abstract

Abstract:

Objective

To investigate the application efficacy of 3D-printed protective caps in patients with traumatic skull defects.

Methods

A retrospective analysis was conducted on the clinical data of 31 patients with traumatic brain injury (TBI) who underwent decompressive craniectomy (DC) in the Neurosurgery Department of the First Affiliated Hospital of Anhui Medical University from December 2023 to October 2025. The patients were divided into a cap-wearing group (15 cases) and a control group (16 cases) based on whether they wore 3D printed protective caps after surgery. Follow up for 3 months after surgery, observe and compare the incidence of subdural fluid accumulation, complications, and prognosis between the two groups of patients.

Results

During the follow-up period, 14 patients developed subdural fluid accumulation after surgery, including 1 case (6.7%) in the cap-wearing group and 13 cases (81.3%) in the control group. The incidence of subdural effusion and the maximum thickness of subdural effusion were compared between the two groups of patients, and the differences were statistically significant (P<0.05); Both groups of patients did not experience adverse events such as skin allergies, damage, or poor wound healing. The Glasgow outcome scale-extended of the cap-wearing group at 3 months after surgery was significantly higher than that of the control group, and the difference was statistically significant (P<0.05).

Conclusions

The 3D-printed protective cap can reduce the risk of subdural effusion after DC in patients with TBI, and improve patient prognosis.

Key words: 3D printing, Traumatic brain injury, Decompressive craniectomy, Skull defect, Subdural effusion

Xiang Mao, Li Pan, Lizheng Xie, Xiao Wu. Application of 3D-printed skull protective cap in patients with traumatic skull defects[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2026, 12(02): 108-112.

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References 16

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项目	佩戴组（n=15）	对照组（n=16）	t值	P值
性别[例（%）]				0.853
男	8（53.3）	8（50.0）
女	7（46.7）	8（50.0）
年龄（岁，±s）	52.93±14.74	55.93±14.96	0.563	0.578
颅骨缺损面积（cm²，±s）	60.49±13.22	60.17±11.05	0.072	0.943
术前GCS评分（分，±s）	9.00±2.61	9.00±3.03	0.450	0.656
血肿体积（mL，±s）	30.68±9.07	28.63±4.96	0.785	0.439
术前中线位移距离（mm，±s）	10.23±2.13	9.79±1.75	0.628	0.535

项目	佩戴组（n=15）	对照组（n=16）	t值	P值
性别[例（%）]				0.853
男	8（53.3）	8（50.0）
女	7（46.7）	8（50.0）
年龄（岁，±s）	52.93±14.74	55.93±14.96	0.563	0.578
颅骨缺损面积（cm²，±s）	60.49±13.22	60.17±11.05	0.072	0.943
术前GCS评分（分，±s）	9.00±2.61	9.00±3.03	0.450	0.656
血肿体积（mL，±s）	30.68±9.07	28.63±4.96	0.785	0.439
术前中线位移距离（mm，±s）	10.23±2.13	9.79±1.75	0.628	0.535

分组	ICC（95%CI）
测量者内
测量者1.1 vs测量者1.2	0.939（0.604~0.970）
测量者2.1 vs测量者2.2	0.974（0.814~0.987）
测量者间
测量者1.1 vs测量者2.1	0.990（0.924~0.995）
测量者1.2 vs测量者2.2	0.966（0.761~0.983）
测量者1.1 vs测量者2.2	0.978（0.834~0.989）
测量者1.2 vs测量者2.1	0.948（0.655~0.975）

分组	ICC（95%CI）
测量者内
测量者1.1 vs测量者1.2	0.939（0.604~0.970）
测量者2.1 vs测量者2.2	0.974（0.814~0.987）
测量者间
测量者1.1 vs测量者2.1	0.990（0.924~0.995）
测量者1.2 vs测量者2.2	0.966（0.761~0.983）
测量者1.1 vs测量者2.2	0.978（0.834~0.989）
测量者1.2 vs测量者2.1	0.948（0.655~0.975）

项目	佩戴组（n=15）	对照组（n=16）	t值	P值
硬膜下积液发生率[例（%）]	1（6.7）	13（81.3）		<0.001
硬膜下积液最大厚度（mm，±s）	3.31±1.28	6.89±1.78	6.390	<0.001
GOSE评分（分，±s）	5.73±1.33	4.56±0.81	2.971	0.006

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