Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent

Introduction. In cranioplasty, pinwheel-shaped titanium mini plates are frequently used to cover bone defects produced by burr holes, and it is common to insert screws through only a few of the holes in cranial flap fixation. Presentation of Case. A 69-year-old man who had undergone clipping surgery...

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Main Authors: Shoko Merrit Yamada, Katsuya Gorai, Koichi Gonda
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2019/5709285
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author Shoko Merrit Yamada
Katsuya Gorai
Koichi Gonda
author_facet Shoko Merrit Yamada
Katsuya Gorai
Koichi Gonda
author_sort Shoko Merrit Yamada
collection DOAJ
description Introduction. In cranioplasty, pinwheel-shaped titanium mini plates are frequently used to cover bone defects produced by burr holes, and it is common to insert screws through only a few of the holes in cranial flap fixation. Presentation of Case. A 69-year-old man who had undergone clipping surgery for subarachnoid hemorrhage 16 years previously visited our clinic because a titanium plate had penetrated his scalp one month after he was hit on the head by a wall cabinet. Imaging studies revealed that part of the titanium plate had bent outwards and penetrated the skin. The plate was surgically removed, a relief skin incision was made 6 cm posterior to the skin defect to suture the defected portion without causing tension, and a skin graft was applied to the relief skin incision portion. Two months after the maneuver, the skin graft had been successfully incorporated without infection. Discussion. Even after the subcutaneous and the cutaneous tissue have completely covered the pinwheel-shaped titanium mini plate, an edge without screw fixation can be easily bent by a hard blow to the overlying scalp. We recommend fixation of pinwheel-shaped titanium plates used in cranioplasty through all screw holes to protect against the plate being bent.
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spelling doaj-art-646c7d9d40ac4ba5ae277b60dfb469682025-08-20T02:23:52ZengWileyCase Reports in Surgery2090-69002090-69192019-01-01201910.1155/2019/57092855709285Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being BentShoko Merrit Yamada0Katsuya Gorai1Koichi Gonda2Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa 213-8507, JapanDepartment of Plastic Surgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa 213-8507, JapanDepartment of Plastic Surgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa 213-8507, JapanIntroduction. In cranioplasty, pinwheel-shaped titanium mini plates are frequently used to cover bone defects produced by burr holes, and it is common to insert screws through only a few of the holes in cranial flap fixation. Presentation of Case. A 69-year-old man who had undergone clipping surgery for subarachnoid hemorrhage 16 years previously visited our clinic because a titanium plate had penetrated his scalp one month after he was hit on the head by a wall cabinet. Imaging studies revealed that part of the titanium plate had bent outwards and penetrated the skin. The plate was surgically removed, a relief skin incision was made 6 cm posterior to the skin defect to suture the defected portion without causing tension, and a skin graft was applied to the relief skin incision portion. Two months after the maneuver, the skin graft had been successfully incorporated without infection. Discussion. Even after the subcutaneous and the cutaneous tissue have completely covered the pinwheel-shaped titanium mini plate, an edge without screw fixation can be easily bent by a hard blow to the overlying scalp. We recommend fixation of pinwheel-shaped titanium plates used in cranioplasty through all screw holes to protect against the plate being bent.http://dx.doi.org/10.1155/2019/5709285
spellingShingle Shoko Merrit Yamada
Katsuya Gorai
Koichi Gonda
Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
Case Reports in Surgery
title Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
title_full Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
title_fullStr Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
title_full_unstemmed Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
title_short Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent
title_sort pinwheel shaped titanium plates should be fixed to the skull using all screw holes to protect the plates from being bent
url http://dx.doi.org/10.1155/2019/5709285
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