TITLE:
Double J Fixation after Craniotomy: Technical Description of a Modification Method for Bone Flap Fixation (Hiederov Method)
AUTHORS:
Hieder Al-Shami, Ahmed M. Salah, Mohamed Fathy Adel Ali
KEYWORDS:
Craniotomy, Bone Flap Fixation, Miniplate Fixation
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.10 No.3,
May
8,
2020
ABSTRACT: Background: Fixation of bone flap following craniotomy is usually achieved by synthetic materials. In rural and poor funding areas, innovation for cheap, safe and applicable material is needed. Purpose: The aim is to assess our new innovative technique in bone flap fixation against traditional techniques. Patients and Methods: The study was a prospective randomized controlled study enrolled at Al-Amal Hospital and Al-Ahly Bank Hospital from 2014-2019. Forty-eight patients were randomized in the study. Group A (24 patients) underwent titanium miniplate fixation while group B (24 patients) underwent our new technique. The new technique is double J tunnels performed by craniotome on either side of the bone (flap and skull sides), then a Prolene suture is passed through the shared stem of J’ holes and secured in the wrapped side of J’s holes and tying it tightly. Both techniques were examined against fixation time, rigidity, offset and final judgment postoperatively. Result: There was no statistically significant difference in using both techniques as regard fixation time. Our new technique was not inferior to the traditional one in achieving rigidity (p > 0.05). The final postoperative assessment was as equal as that seen in miniplate fixation. Conclusion: This technique is a simple, easy, cheap and effective method of fixing craniotomy bone flap.