Serlo W, MD, PhD (1),
Ashammakhi N, MD, PhD (2), Törmälä P (3) and
Waris T, MD, PhD (4).
1. Department of Paediatrics, Oulu University Hospital
2. Department of Surgery, Oulu University Hospital
3. Institute of Biomaterials,
Tampere University of Technology
4. Department of Surgery,
Tampere University Hospital and University of Tampere
Oulu University Science Day, 18 Feb 2003, Oulu, Finland.
Aim
Recent advances in bioabsorbable devices have introduced tacks that do
not require tapping. This may help to reduce operative time and, consequently,
costs. The goal of this study was to demonstrate the feasibility of a
new method of cranial bone osteofixation using novel bioabsorbable tacks
and plates instead of screws.
Materials and methods
A 36-year-old man presented for elective cranioplasty to reconstruct a
large frontal cranial bone defect that followed a decompression operation
performed because of a head injury sustained 6 months previously. Cranioplasty
was performed using split parietal bone grafts to reconstruct the defect.
Bone grafts were fixed together and to the skull using self-reinforced
(SR) poly(L/DL)lactide [SR-poly(L/DL)lactide] (70/30) (Biosorb FX) plates
(n = 10) and tacks (n = 98). The plates were 0.6 mm thick, 102 mm long,
and 12 mm wide. The tacks had a maximum thread diameter of 2 mm and a
length of 6 mm. The tacks used did not require any tapping procedure,
and they were applied using a special applicator gun. Stable and secure
fixation was obtained during surgery.
Result
The postoperative period was uneventful, except for delayed epithelialization
of a small area (1 x 0.5 cm) over the frontal skin that healed later.
One year after surgery, the cosmetic result was excellent, and no complications
were detected.
Conclusion
Stabilization of large cranial bone pieces can be achieved using bioabsorbable
SR-poly(L/DL)lactide plates and tacks, with excellent cosmetic results.
The method is thought to be reliable and may help to reduce operative
time.
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