Cranial reconstruction with titanium clamps in frontal comminuted depressed skull fractures. 2013

Xinwei Li, and Chong Qian, and Shuxu Yang, and Yili Chen, and Weijun Sun, and Yirong Wang
Department of Neurosurgery, Sir Run Run Shaw Hospital, The Affiliated Hospital of Medical College, Zhejiang University, Qingchun East Road No. 3, 310016, Hangzhou, China. ghostmmx@hotmail.com

OBJECTIVE Frontal comminuted depressed skull fractures need special attention due to complications and aesthetics. The optimal method of reconstruction and fixation of frontal bone fragments remains a matter of discussion. We explored the advantages of reconstruction of frontal bone with titanium clamps. METHODS From May 2007 to September 2011, we performed 18 craniotomies with titanium clamps to fix the cranial fragments. On the beginning of craniotomy, single-window craniotomy (n = 11) and 2-window craniotomy (n = 9) were designed. After dural closure and frontobasal reconstruction, these fragments were fixed with titanium clamps. A helical CT scan was obtained after operation and a 3-dimensional technique was performed to evaluate the postoperative results. RESULTS The CranioFix titanium clamp system was applied in 18 patients. No intraoperative and postoperative complications related to clamps were observed. The number of bone fragments ranged from 2 to 5 (average 3.3 pieces) while the number of clamps ranged from 3 to 8 (average 5.8). The time of refixation ranged from 5 to 17 minutes with an average of 9.4 minutes. Obvious statistical significance (P = 0.015) was found in postoperative CT scan results between single-window group and 2-window group, although it is not statistically different in intraoperative subjective valuation (P > 0.05). In all 18 cases, the alignment of fragments was precise, the fixation rigid, and the aesthetic result satisfying. CONCLUSIONS Reconstruction of the forehead by refixation of bone fragments with titanium clamps in frontal depressed skull fractures is safe and suitable. This technique promises to be a good alternative in the repair of frontal comminuted depressed skull fractures. The simplicity, reliable fixation, and fast handling are its prominent features.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003399 Craniotomy Surgical incision into the cranium. Craniectomy,Craniectomies,Craniotomies
D005260 Female Females
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000058 Accidental Falls Falls due to slipping or tripping which may result in injury. Falls, Accidental,Falling,Falls,Slip and Fall,Accidental Fall,Fall and Slip,Fall, Accidental
D000063 Accidents, Traffic Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles. Traffic Collisions,Traffic Crashes,Traffic Accidents,Accident, Traffic,Collision, Traffic,Collisions, Traffic,Crashes, Traffic,Traffic Accident,Traffic Collision
D014025 Titanium A dark-gray, metallic element of widespread distribution but occurring in small amounts with atomic number, 22, atomic weight, 47.867 and symbol, Ti; specific gravity, 4.5; used for fixation of fractures.
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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