A new method for surgical repair of impression fractures of the cranial vault and frontal sinus with rivet-like titanium clamps

Abstract

Conventional methods of stabilizing fragments in cranial impression fracture include the use of threads, wires, plates, etc. A new approach to facilitate this surgery is the use of titanium clamps, presented here in five cases, including one with frontal sinus fracture. Surgery was performed on admission day, with the exception of the sinus fracture. Compared with the use of mini- and microplates, the procedure was simple and short. The fixation was very rigid and the esthetic result excellent in all five cases. Skin irritation was minimal, compared with that from miniplates. Computed tomography and MRI compatibility due to artifacts are identical to those with miniplates.

Titanium Clamps for a Simple Low-Profile Autologous Osteosynthesis in the Reconstruction of Posttraumatic Craniofacial Convexital Skeletal Disruption

“…Miniplates and screws come closest to the titanium clamps in their utility for cranialfacial bone fixation but have the drawbacks alluded to above: more time consuming to apply, more expensive, and may be more prone to producing scalp irritation. 8,17 Conclusion A surgical series of autologous reconstruction of PTCD using the titanium clamp (CranioFix) is presented in this study. The technique was successful, free of complications including SSI, in a 6-year prospective consecutive cohort of patients in a neurosurgery practice from a developing country.…”

“…The technique has greatly helped facilitate a highly functional and aesthetic reconstruction of these otherwise disfiguring, and possibly distressing, defects. 3,5,8 The postoperative follow-up period has ranged from 2 to 73 months, at least a third of the patients for longer than 36 months. The procedure has also been, mercifully, free of SSI to date.…”

“…It also appears the cheapest of all. 8,17 Not only are plates and screws more cumbersome, somewhat, to handle, compared with the Cra-nioFix clamps, they are also much more expensive. They may also produce scalp irritation.…”

“…Based on the scientific principles of orthopedic surgery in the management of open fractures (generous debridement/irrigation 19 and rigid fixation of fracture fragments), it appears the technique can be applied even outside the low-resource developing countries. 5,8…”

Primary reconstruction of depressed skull fracture — The changing scenario

“…The conventional methods of stabilizing fragments in cranial depression fracture include the use of threads, wires and plates 14 . Titanium is an useful tool in the fixation of bone fragments in the repair of depressed skull fractures 8 .…”