- Medical E Unit, Khyber Teaching Hospital, Peshawar, Pakistan
- Department of Neurosurgery, Combined Military Hospital, Peshawar, Pakistan
Syed Sarmad Bukhari
Department of Neurosurgery, Combined Military Hospital, Peshawar, Pakistan
DOI:10.4103/2152-7806.156774Copyright: © 2015 Bukhari SS. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
How to cite this article: Bukhari SS, Junaid M. Mini titanium plates and screws for cranial bone flap fixation; an experience from Pakistan. Surg Neurol Int 08-May-2015;6:75
How to cite this URL: Bukhari SS, Junaid M. Mini titanium plates and screws for cranial bone flap fixation; an experience from Pakistan. Surg Neurol Int 08-May-2015;6:75. Available from: http://surgicalneurologyint.com/surgicalint_articles/mini-titanium-plates-screws-cranial-bone-flap-fixation/
The biocompatibility and osseointegrative qualities of the element titanium have allowed its extensive use medical science especially Orthopedics and Neurosurgery, effectively replacing its predecessor, steel. Historically, nonabsorbable sutures were used to anchor the bone flap following a craniotomy but have been associated with functional and cosmetic defects as well as nonunion and failure postoperatively.[
We have been using titanium miniplates at our department since 2011. A total of 71 patients (42 male and 29 female) underwent a craniotomy for supratentorial access for a variety of causes including tumor excision and aneurysm clipping followed by a cranial bone flap fixation with titanium miniplates till March 2014 by one surgeon. Craniotomies for posterior fossa approaches are not performed in our unit for lack of specialized equipment and craniotomies for head trauma were not included in this group of patients. Postoperatively the patients were followed up for a period of 3–12 months and the results were objectively assessed with visual inspection, computed tomography/magnetic resonance imaging (CT/MRI) to assess for appearance, physical deformity, subsidence, or displacement of the bone flap. Subjective data from the patients was not obtained. The age range was 2–77 years with a mean age of 40.07 years and a standard deviation of +/- 18.753 years. Intracranial lesion size ranged from 3 × 2 cm to 7 × 5 cm. The changes of local incision and general condition were observed.
Minor complications were reported in three patients with a subcutaneous effusion occurring in two patients who were treated with needle aspiration on day 10 and one patient developing a mild postoperative wound infection, which was treated with dressings and oral antibiotics. CT scan showed good repositioning of the flap and edge to edge apposition at 2 weeks after operation. During follow up, the skull had good appearance without any discharge, local deformity or effusion. Repeat CT/MRI showed no subsidence or displacement of cranial flap or artifacts. Titanium plates, however, can cause a small distortion in the image, up to 0.5 cm, on CT and MRI scans.
Titanium miniplates were introduced for rigid fixation of cranial bone flaps following craniotomies. They are currently available in 0.3-mm thickness, which does not require indentation of the bone to hide the surface thickness. This has resulted in excellent functional and cosmetic outcomes [
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