[Technique for embedding a titanium miniplate in the forehead that avoids objectionable bulges].
OBJECTIVE
As the fixation of cranial bone flaps with titanium miniplates may produce esthetically objectionable bulges especially on the forehead covered with thin scalp, we developed a technique that solves this problem.


METHODS
The study material consisted of 19 consecutive sides treated by frontotemporal cranioplasty using free bone flaps and miniplate-fixation. A pit matching the width and depth of the miniplate was drilled on the outer table, the miniplate was embedded in the pit in the forehead and fixed with screws.


RESULTS
Fixation of the bone flap was successful on 18 sides. In one instance the outer table lost the strength to sustain the screws due to excessively deep drilling. No esthetically objectionable bulges were noted even in patients with a thin scalp cover.


CONCLUSIONS
This simple technique avoids the development of bulges and provides satisfactory cosmetic results. The key to this technique is preservation of the outer table at the bottom of the pit (more than 1 mm in thickness) to assure the stability of the fixation screws.
Shimizu
Satoru
S
Department of Neurosurgery, Yokohama Stroke and Brain Center, 1-2-1 Takigashira, Isogo-ku, Yokohama-shi, Kanagawa 235-0012, Japan.
Hagiwara
Hiroyuki
H
Nakayama
Kenji
K
Fujii
Kiyotaka
K
D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005624:Frontal Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014025:Titanium
D014025:Titanium