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Loss of Skull Fixation

Last Updated: September 27, 2018

Figure 1:  The main axis of fixation (a line connecting the single pin to the middle of the double pins is not crossing the midline sagittal plane of the patient’s head.  This configuration significantly increases the risk of fixation failure.

Reasons for Fixation Failure

Displacement of three-point pin fixation occurs at some point in the career of every neurosurgeon. The patient’s head can move out of the pins despite correct pin placement and presumably appropriate fixation. The fixation failure often occurs when there is stress on the fixation points, such as during drilling, bone work, or elevation of the bone flap. Counter tension can decrease the risk of clamp failure. For more details about appropriate clamp application and complication avoidance, refer to the following section...