Craniotomy bone flap fixation: revisiting the use of bone struts

Area of Science:

• Neurosurgery
• Orthopedic Surgery

Background:

• Bone flap fixation is crucial after craniotomy, with current methods lacking an ideal balance of efficacy, safety, and cost.
• Existing techniques for cranial bone fixation face challenges in achieving optimal cosmetic outcomes and bony fusion while minimizing complications and costs.

Purpose of the Study:

• To evaluate the efficacy and outcomes of the strut technique for bone flap fixation in craniotomy.
• To highlight a potentially underutilized method for achieving ideal bone flap fixation, addressing infection prevention, cosmesis, bony fusion, cost, and complication reduction.

Main Methods:

• A retrospective review of 300 craniotomies performed over 8 years.
• Analysis of operative notes and follow-up records for 81 cases utilizing the strut technique for bone flap fixation.

Main Results:

• Excellent bony contour was achieved in 19 cases.
• Minor contour irregularities (one depression, one ridge) were noted in two cases.
• No repeat surgeries were required for either surgical or cosmetic reasons.

Conclusions:

• The strut technique for bone flap fixation is a viable and effective method.
• This technique meets the criteria for an ideal fixation strategy, offering excellent cosmetic and bony fusion results.
• The neurosurgical community should consider the strut technique as a reliable option for bone flap fixation.