Pin penetration depths in the neurocranium using a three-pin head fixation device
Abstract In estimated 10–15% of neurosurgical interventions employing a conventional three-pin head fixation device (HFD) the patient’s head loses position due to slippage. At present no scientifically based stability criterion exists to potentially prevent the intraoperative loss of head position o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-02-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-55227-x |
| _version_ | 1797275189973614592 |
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| author | René Machts Martina Schindler Heike Unterhauser-Chwastek Jan Mertens Katharina Faust |
| author_facet | René Machts Martina Schindler Heike Unterhauser-Chwastek Jan Mertens Katharina Faust |
| author_sort | René Machts |
| collection | DOAJ |
| description | Abstract In estimated 10–15% of neurosurgical interventions employing a conventional three-pin head fixation device (HFD) the patient’s head loses position due to slippage. At present no scientifically based stability criterion exists to potentially prevent the intraoperative loss of head position or skull fractures. Here, data on the skull penetration depth both on the single and two-pin side of a three-pin HFD are presented, providing scientific evidence for a stability criterion for the invasive three-pin head fixation. Eight fresh, chemically untreated human cadaveric heads were sequentially pinned 90 times in total in a noncommercially calibrated clamp screw applying a predefined force of 270 N (approximately 60 lbf) throughout. Three head positions were pinned each in standardized manner for the following approaches: prone, middle fossa, pterional. Titanium-aluminum alloy pins were used, varying the pin-cone angle on the single-pin side from 36° to 55° and on the two-pin side from 25° to 36°. The bone-penetration depths were directly measured by a dial gauge on neurocranium. The penetration depths on the single-pin side ranged from 0.00 mm (i.e., no penetration) to 6.17 mm. The penetration depths on the two-pin side ranged from 0.00 mm (no penetration) to 4.48 mm. We measured a significantly higher penetration depth for the anterior pin in comparison to the posterior pin on the two-pin side in prone position. One pin configuration (50°/25°) resulted in a quasi-homogenous pin depth distribution between the single- and the two-pin side. Emanating from the physical principle that pin depths behave proportionate to pin pressure distribution, a quasi-homogenous pin penetration depth may result in higher resilience against external shear forces or torque, thus reducing potential complications such as slippage and depressed skull fractures. The authors propose that the pin configuration of 50°/25° may be superior to the currently used uniform pin-cone angle distribution in common clinical practice (36°/36°). However, future research may identify additional influencing factors to improve head fixation stability. |
| first_indexed | 2024-03-07T15:09:47Z |
| format | Article |
| id | doaj.art-0fa06951a2d94bf6bff07afc090f09c7 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-07T15:09:47Z |
| publishDate | 2024-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-0fa06951a2d94bf6bff07afc090f09c72024-03-05T18:41:33ZengNature PortfolioScientific Reports2045-23222024-02-0114111010.1038/s41598-024-55227-xPin penetration depths in the neurocranium using a three-pin head fixation deviceRené Machts0Martina Schindler1Heike Unterhauser-Chwastek2Jan Mertens3Katharina Faust4Pro Med Instruments GmbH, Part of Black Forest Medical GroupPro Med Instruments GmbH, Part of Black Forest Medical GroupDepartment of Neurosurgery, Bundeswehrkrankenhaus BerlinPro Med Instruments GmbH, Part of Black Forest Medical GroupDepartment of Neurosurgery, Charité University MedicineAbstract In estimated 10–15% of neurosurgical interventions employing a conventional three-pin head fixation device (HFD) the patient’s head loses position due to slippage. At present no scientifically based stability criterion exists to potentially prevent the intraoperative loss of head position or skull fractures. Here, data on the skull penetration depth both on the single and two-pin side of a three-pin HFD are presented, providing scientific evidence for a stability criterion for the invasive three-pin head fixation. Eight fresh, chemically untreated human cadaveric heads were sequentially pinned 90 times in total in a noncommercially calibrated clamp screw applying a predefined force of 270 N (approximately 60 lbf) throughout. Three head positions were pinned each in standardized manner for the following approaches: prone, middle fossa, pterional. Titanium-aluminum alloy pins were used, varying the pin-cone angle on the single-pin side from 36° to 55° and on the two-pin side from 25° to 36°. The bone-penetration depths were directly measured by a dial gauge on neurocranium. The penetration depths on the single-pin side ranged from 0.00 mm (i.e., no penetration) to 6.17 mm. The penetration depths on the two-pin side ranged from 0.00 mm (no penetration) to 4.48 mm. We measured a significantly higher penetration depth for the anterior pin in comparison to the posterior pin on the two-pin side in prone position. One pin configuration (50°/25°) resulted in a quasi-homogenous pin depth distribution between the single- and the two-pin side. Emanating from the physical principle that pin depths behave proportionate to pin pressure distribution, a quasi-homogenous pin penetration depth may result in higher resilience against external shear forces or torque, thus reducing potential complications such as slippage and depressed skull fractures. The authors propose that the pin configuration of 50°/25° may be superior to the currently used uniform pin-cone angle distribution in common clinical practice (36°/36°). However, future research may identify additional influencing factors to improve head fixation stability.https://doi.org/10.1038/s41598-024-55227-xBone responseLoss of head fixationHead fixation deviceHead slippageSkull clampCadaveric specimen |
| spellingShingle | René Machts Martina Schindler Heike Unterhauser-Chwastek Jan Mertens Katharina Faust Pin penetration depths in the neurocranium using a three-pin head fixation device Scientific Reports Bone response Loss of head fixation Head fixation device Head slippage Skull clamp Cadaveric specimen |
| title | Pin penetration depths in the neurocranium using a three-pin head fixation device |
| title_full | Pin penetration depths in the neurocranium using a three-pin head fixation device |
| title_fullStr | Pin penetration depths in the neurocranium using a three-pin head fixation device |
| title_full_unstemmed | Pin penetration depths in the neurocranium using a three-pin head fixation device |
| title_short | Pin penetration depths in the neurocranium using a three-pin head fixation device |
| title_sort | pin penetration depths in the neurocranium using a three pin head fixation device |
| topic | Bone response Loss of head fixation Head fixation device Head slippage Skull clamp Cadaveric specimen |
| url | https://doi.org/10.1038/s41598-024-55227-x |
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