A sterile artificial skull allows a proper anatomical contour of the implant. This is not required when using a prebent mesh.
When using the fan-shaped plate, the outer circumference of the mesh is widest in the area of the infraorbital rim. The mesh should be trimmed so that the outer circumference is as small as possible but still provides enough width to cover the defect.
The necessity for screw fixation varies with the type of material used and nature of the fracture.
It is important to use a plate large enough to span the entire defect.