{"id":"1c51ec3b-bc20-47cf-bdbf-4aafd1e8e9be","slug":"sinking-of-bone-flap-looking-beyond-cosmesis-and-costs","title":"Sinking of bone flap-looking beyond cosmesis and costs","authors":["Srikant Reddy","Rajesh Alugolu","Ashish Kumar"],"abstract":"Background: Decompressive craniectomy is performed to manage raised intracranial hypertension, necessitating subsequent bone flap replacement or cranioplasty. Complications arising from bone flap replacement, particularly the phenomenon termed 'sunken bone flap syndrome', have not been extensively highlighted in the literature. This syndrome can lead to significant neurological deficits beyond mere cosmetic concerns. Methods: A case study was conducted involving a 35-year-old male who underwent craniectomy and subsequent cranioplasty. The patient experienced progressive neurological deterioration, which was evaluated through clinical assessment and computed tomography (CT) imaging. Surgical re-exploration was performed to address the complications associated with the bone flap. Results: CT imaging revealed a sunken bone flap causing midline shift and mass effect, with the bone clamps losing grip on the flap. During re-exploration, metallic clamps were found fixed to the skull, and adhesiolysis was performed. Post-operative observations indicated improvement in neurological function following proper fixation of the bone flap. Conclusion: The findings underscore the importance of secure fixation of the bone flap during cranioplasty to prevent complications such as sunken bone flap syndrome. This case highlights the need for careful surgical techniques and consideration of patient-specific factors, particularly in those with ventriculo-peritoneal shunts. Keywords: decompressive craniectomy, cranioplasty, sunken bone flap syndrome, neurological deficits, surgical complications, bone flap fixation","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/1c51ec3b-bc20-47cf-bdbf-4aafd1e8e9be/featured/hero-1782420955646.png","publishDate":"2013-02-20T00:00:00.000Z","doi":"10.4103/2152-7806.107547","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3635/SNI-4-20.pdf"}