The clinical application of a new absorbable fixation clamp in craniotomy closure. A technical note after first experiences with 29 patients

Abstract

Several efforts have been made to provide safe and convenient systems for craniotomy closure. In the past, the only alternative to suture fixation was metal implants. In order to afford a bone flap fixation without leaving durable implants an absorbable fixation system has been developed by Aesculap. In a prospective clinical evaluation we analysed intraoperative handling, position of the bone flap and stability of the connection. The planarity of the bone flaps were analysed in CT-scans on average 2 days after operation. Between September 2006 and October 2007 we performed craniotomy closures with the absorbable craniofix system in 29 patients. The intraoperative handling is easy when using up to 3 craniofix clamps. To ensure stability, 3 or in some cases 2, clamps are needed. Smaller bone flaps with an equal thickness of the bone tend to show a better position in the CT. We observed no complications. The absorbable fixation clamp is safe and convenient in small craniotomies which are properly fixed with 3 clamps. More than 3 clamps are unwieldly to use.