title: The clinical application of a new absorbable fixation clamp  in craniotomy closure. A technical note after first experiences  with 29 patients.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. johannes.lemcke@ukb.de
authors.forename: J
authors.initials: J
authors.lastname: Lemcke
authors.forename: U
authors.initials: U
authors.lastname: Meier
authors.forename: F
authors.initials: F
authors.lastname: Al-Zain
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003399:Craniotomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D013524:Surgical Flaps / Q000706:statistics & numerical data; D013525:Surgical Instruments / Q000009:adverse effects / Q000706:statistics & numerical data*; D013537:Sutures / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology