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Updated: Jun 20, 2026
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
The clinical application of a new absorbable fixation clamp in craniotomy closure. A technical note after first
1Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. johannes.lemcke@ukb.de
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.
