Osteology of the pediatric skull. Considerations of halo pin placement.
METHODS
Computed tomography scans of the heads of 48 normal children were measured for skull thickness in areas of routine halo pin placement. The thickest and thinnest areas were noted.


OBJECTIVE
The head computed tomography scans were measured to identify consistently thin areas in the pediatric skull that should be avoided when pins are placed.


BACKGROUND
Complications of halo pin placement in children are common, including loosening and dislodgment, infection and penetration.


METHODS
Normal head computed tomography scans of 48 normal children, 10 years old and under, were divided into four age groups. Total skull thickness was measured in five areas at the level of halo insertion.


RESULTS
There was a trend toward increasing skull thickness with age. There was a large variation in skull thickness at each area within and between age groups. None of the standard pin sites was consistently thicker. Even up to 10 years of age, the average thinnest area was only 1.9 mm.


CONCLUSIONS
There is no "safe area" for halo pin placement in the pediatric skull. Limited preoperative head computed tomography scans are recommended to determine safe areas for pin placement.
Wong
W B
WB
Children's Rehabilitative Services, Phoenix, Arizona.
Haynes
R J
RJ
D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D016267:External Fixators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012016:Reference Values; D012886:Skull / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014143:Traction / Q000295:instrumentation*