Cranial reconstruction with titanium clamps in frontal comminuted depressed skull fractures.
OBJECTIVE
Frontal comminuted depressed skull fractures need special attention due to complications and aesthetics. The optimal method of reconstruction and fixation of frontal bone fragments remains a matter of discussion. We explored the advantages of reconstruction of frontal bone with titanium clamps.


METHODS
From May 2007 to September 2011, we performed 18 craniotomies with titanium clamps to fix the cranial fragments. On the beginning of craniotomy, single-window craniotomy (n = 11) and 2-window craniotomy (n = 9) were designed. After dural closure and frontobasal reconstruction, these fragments were fixed with titanium clamps. A helical CT scan was obtained after operation and a 3-dimensional technique was performed to evaluate the postoperative results.


RESULTS
The CranioFix titanium clamp system was applied in 18 patients. No intraoperative and postoperative complications related to clamps were observed. The number of bone fragments ranged from 2 to 5 (average 3.3 pieces) while the number of clamps ranged from 3 to 8 (average 5.8). The time of refixation ranged from 5 to 17 minutes with an average of 9.4 minutes. Obvious statistical significance (P = 0.015) was found in postoperative CT scan results between single-window group and 2-window group, although it is not statistically different in intraoperative subjective valuation (P > 0.05). In all 18 cases, the alignment of fragments was precise, the fixation rigid, and the aesthetic result satisfying.


CONCLUSIONS
Reconstruction of the forehead by refixation of bone fragments with titanium clamps in frontal depressed skull fractures is safe and suitable. This technique promises to be a good alternative in the repair of frontal comminuted depressed skull fractures. The simplicity, reliable fixation, and fast handling are its prominent features.
Department of Neurosurgery, Sir Run Run Shaw Hospital, The Affiliated Hospital of Medical College, Zhejiang University, Qingchun East Road No. 3, 310016, Hangzhou, China. ghostmmx@hotmail.com
Xinwei
X
Li
Chong
C
Qian
Shuxu
S
Yang
Yili
Y
Chen
Weijun
W
Sun
Yirong
Y
Wang
D000058:Accidental Falls; D000063:Accidents, Traffic; D003399:Craniotomy / Q000295:instrumentation*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D020204:Skull Fracture, Depressed / Q000601:surgery*; D014025:Titanium; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D055815:Young Adult
D014025:Titanium