Serlo W (1), Ashammakhi N (2), Länsman S (2), Törmälä P (3), Waris T (4)

1. Department of Surgery, Oulu University Hospital, P.O. Box 22, FIN-90221 Oulu, Finland.
2. Department of Pathology, Oulu University Hospital, P.O. Box 22, FIN-90221 Oulu, Finland.
3. Institute of Biomaterials, Tampere University of Technology, P.O. Box 589, FIN-33101 Tampere, Finland.
4. Department of Surgery, Tampere University Hospital and University of Tampere, Tampere, Finland

Aim
To report on the feasibility of applying bioabsorbable tacks using new tack-shooter to fix bioabsorbable plates applied endocranially for the correction of three trigonocephaly cases.

Materials and methods
A 1.5-2 cm broad supra-orbital bar (bandeau) was raised, and reshaped. The corrected shape was maintained using Biosorb plate and tacks applied on the endocranial side of the bar. We used tacks to fix plates and bones. The tacks did not require tapping neither tightening, since they are shot using a tack-shooter directly into drill holes in the bone. The plate extended few centimeters laterally beyond the edge of the supraorbital bar and it was fixed with Biosorb miniscrews and/or tacks to the temporal bones. Molded other bone pieces were fixed using Biosorb plates, screws and/or tacks.

Results
The technique of using tacks was easy to apply and it provided secure osteofixation. Cosmetic results were excellent and no complications were encountered except for palpability of plate edges on the right side of the skull in one case.

Conclusion
Use of bioabsorbable tacks and plates provides secure osteofixation when used for correction of trigonocephaly with potential to reduce operative time, risks and costs.

Keywords: Bioabsorbable, Biodegradable, Cranioplasty, Tacks, Tack-shooter