Three Cases of Scalp Rupture and Cosmetic Deformity caused by a Fixation Plate after Craniotomy

Wakui, Daisuke; Nagashima, Goro; Ueda, Toshihiro; Takada, Tatsuro; Tanaka, Yuichiro; Hashimoto, Takuro

doi:10.7887/jcns.21.138

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…However, adverse events associated with titanium plates are reported especially for pediatric cases implanted for a long period. Especially for periatric patients, these are very important points that adverse outcomes include deviation of the plates, inhibition of cranial bone growth, aberrance into the brain, scalp thinning, and plate exposure [ 6 , 7 , 9 , 14 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Bioresorbable plate fracture after cranioplasty caused by head injury: a pediatric case

et al. 2021

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Background Recently, bone fixation materials have been developed as surgical materials. Bioabsorbable materials offer several advantages over other materials and are widely used. We report a rare case of the fracture of bioresorbable plates caused by head injury and describe some considerations. Case description A 6-year-old boy suffered from consciousness disturbance. He was admitted to our hospital and diagnosed with left frontal subcortical hemorrhage due to ruptured arteriovenous malformation (AVM). He received the surgery of removal of the AVM with decompressive craniectomy. He was discharged without any neurologic deficit and underwent the cranioplasty 4 months after the initial surgery. Two months after the last treatment, he was fallen and hit his left frontal head. The next day, he noticed an abnormal bulge in the injured area. We diagnosed the bulging as cerebrospinal fluid leakage because of the dural tear. The repairment of dural tear was performed. We found that two bioresorbable plates used by cranioplasty were both cracked, and the dura mater beneath them was torn. We repaired the damaged dura with an artificial dura mater. After surgery, cerebrospinal fluid leakage did not occur. Conclusion It has been reported that the durability of bioresorbable plates is no less than that of titanium plates. We experienced a relatively rare case in which bioabsorbable plate used for bone fixation was damaged due to head trauma. After craniotomy or cranioplasty using bioresorbable plates, special attention should be paid to head trauma that involves bone flap sinking force and side bending stress.

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Section: Discussionmentioning

confidence: 99%

Bioresorbable plate fracture after cranioplasty caused by head injury: a pediatric case

et al. 2021

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“…However, several complications associated with plate fixation have recently been documented including pain and discomfort, protrusion of the plates and/or screws on palpation, skin inflammation, ulcer formation, scalp rupture, and infection of the surrounding tissue. [2][3][4][5] The bioabsorbable plate has since been developed to overcome the complications specific to titanium plates but with equivalent efficacy to the titanium implant system. 6,7 Furthermore, bioabsorbable implants do not interfere with clinical imaging.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frontotemporal Craniotomy for Clipping of Unruptured Aneurysm Using a Diamond-Coated Thread Wire Saw and Reconstruction Using Calcium Phosphate Cement without Metal Fixation

et al. 2023

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Metal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.

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“…They provide easy, rigid, and long-lasting fixation. However, a small but significant number of complications have been reported including skin irritation,[ 7 ] ulcer formation,[ 5 ] scalp rupture,[ 9 ] objectionable bulge,[ 7 8 ] and the migration of the titanium hardware through the skull. [ 1 ] This is the first report of postcraniotomy headache caused by mechanical irritation of the peripheral nerve by titanium miniplates.…”

Section: Introductionmentioning

confidence: 99%

Chronic headache caused by a titanium fixation plate: Report of two cases

Yokoya¹,

Hino²,

Oka³

2017

Surg Neurol Int

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Background:We report two patients with chronic postcraniotomy headache who showed rapid alleviation of pain after removal of titanium miniplates.Case Description:(Case 1) A 26-year-old woman underwent a right frontal craniotomy and excision of the entire cerebral cavernous malformation. Eleven years later, she developed headache. The titanium plate was removed and the patient presented complete amelioration of headache. (Case 2) A 50-year-old man underwent an aneurysm clipping via the lateral supraorbital approach of the left side. One year later, he complained about throbbing pain. Removing the titanium plate led to complete relief of the headache.Conclusion:Titanium miniplate fixation may irritate the deep division of the supraorbital nerve and may cause a chronic headache. Here, we propound the idea that, postcraniotomy, titanium miniplates should not be placed above the temporal fusion line.

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Three Cases of Scalp Rupture and Cosmetic Deformity caused by a Fixation Plate after Craniotomy

Abstract: We report three cases of scalp rupture after cranioplasty using titanium plates ． Case l is a 68 − year

Cited by 5 publications

References 5 publications

Bioresorbable plate fracture after cranioplasty caused by head injury: a pediatric case

Bioresorbable plate fracture after cranioplasty caused by head injury: a pediatric case

Frontotemporal Craniotomy for Clipping of Unruptured Aneurysm Using a Diamond-Coated Thread Wire Saw and Reconstruction Using Calcium Phosphate Cement without Metal Fixation

Chronic headache caused by a titanium fixation plate: Report of two cases

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