gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Nitinol cranial bone flap fixation device for reconstruction of cranial depressed fractures

Meeting Abstract

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  • corresponding author S. Acampora - Neurosurgical Department, IRCCS Neuromed Institute, Pozzilli, Italy
  • A. Isidori - Neurosurgical Department, IRCCS Neuromed Institute, Pozzilli, Italy
  • G. P. Cantore - Neurosurgical Department, IRCCS Neuromed Institute, Pozzilli, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocDI.05.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc178.shtml

Published: May 30, 2008

© 2008 Acampora et al.
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Outline

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Objective: The RollerFix, a new design of MRI compatible implant for fixation of cranial bone flaps, has been used to repair compound depressed fractures of the skull. This device is composed of a single wire of nitinol (nickel-titanium alloy), 0.9 mm in diameter, that is twisted into a double ring with a 13 mm diameter. The rings are joined by two straight wire segments which form a connecting bridge, slightly longer than the interannular distance. The aim of this study was to report our surgical experience in reconstruction of depressed cranial fractures using the same bone fragments raised and wired together with RollerFix.

A total of 12 patients with a mean age of 22.8 years were treated at Neuromed Institute, during the years 2004-2006, for reconstruction of depressed fracture of the skull. Depending on the size of the bone fragments, two to nine RollerFix devices have been applied.

The need for a surgical treatment to repair a cranial depressed fracture, either comminuted or composite, to meet the patients’ aesthetical more than functional expectation, often leads the surgeon to give up any effort to utilize the depressed bone fragments and to take advantage of more complicated techniques of cranioplasty surgery. This choice of re-aligning the bone fragments safely and aesthetically acceptable, results in a more aggressive and expensive surgery. Our experience, even limited, enlights the plastic reconstruction with bone fragments, recovered from the fracture focus and kept together with RollerFix, and limits cranioplasty using different materials, which require just the same an elastic fixation using RollerFix only for comminuted depressed fractures.

The technique is simple, after debridement of the wound the larger bone fragments are raised and wired together with RollerFix to restore the contour of the skull.

RollerFix’s nickel-titanium alloy is not allergenic; it does not cause inflammation or bone resorption at the site of attachment, even in pediatric patients.