Abstract

Background and Objective:Craniotomy bone flaps should be replaced for both cosmetic and protective purposes. Different methods are available commercially. The aim of this study was to assess outcome of bone flap fixation using mini titanium plates and screws.Methods:Between March, 2011 and March, 2014, 71 patients underwent cranial bone flap fixation with mini titanium plates and screws after craniotomy and excision of supratentorial lesions at Combined Military Hospital, Peshawar. There were 42 males and 30 females with a mean age of 40.07. All patients had supratentorial lesions. Intracranial lesion size ranged from 3 cm by 2 cm to 7 cm by 5 cm. The changes of local incision and general condition were observed.Results:Subcutaneous effusion occurred in two patients. One patient developed a mild postoperative wound infection. CT scan showed good repositioning of the flap and edge to edge apposition at two weeks after operation. All the patients were followed up for 12 months post operatively. Skull had good appearance without any discharge and, local deformity or effusion. Repeat CT/MRI showed no subsidence or displacement of cranial flap or artifacts.Conclusion:Mini titanium plate and screw fixation of cranial flaps is a simple, cost effective and safe option for repositioning and immediate stability as compared to traditional sutures.

Highlights

  • The biocompatibility and Osseo-integrative qualities of the element titanium have led to its widespread use in medicine as an in vivo implant

  • Titanium miniplates have been employed for cranial bone flap fixation with excellent results over the years.[4]

  • We present our local experience over a period of three years involving closure of craniotomies with titanium mini plates and give a brief discussion of alternatives available for rigid fixation

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Summary

Introduction

The biocompatibility and Osseo-integrative qualities of the element titanium have led to its widespread use in medicine as an in vivo implant. Every surgery is planned with reconstruction in mind This has not been a priority amongst neurosurgeons, possibly because functional outcome has historically taken precedence over esthetic outcome.[2] Besides the physical appearance, non-rigid fixation of a bone flap following craniotomy has been known to affect overall surgical outcome.[3] Titanium miniplates have been employed for cranial bone flap fixation with excellent results over the years.[4] Here we present our local experience over a period of three years involving closure of craniotomies with titanium mini plates and give a brief discussion of alternatives available for rigid fixation. Methods: Between March 2011 and March 2014, 71 patients underwent cranial bone flap fixation with mini titanium plates and screws after craniotomy and excision of supratentorial lesions at Combined Military Hospital, Peshawar. Conclusion: Mini titanium plate and screw fixation of cranial flaps is a simple, cost effective and safe option for repositioning and immediate stability as compared to traditional sutures

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