Releasing of a Titanium Clamp (Craniofix(®)) Without Mechanical Defect After Craniotomy for Acute Subdural Hemorrhage

After craniotomy, bone flap fixation can be performed using wires, sutures, microplates, and Craniofix®. Well-margined and fixed bone flaps are important not only for postoperative brain protection but also for esthetics. Herein, we report a case of cranioplasty due to bone flap dislocation by Craniofix® clamp loosening after craniotomy with acute subdural hemorrhage removal. Iatrogenic outward force during epidural drain removal adjacent to Craniofix®, insertion of the clamp around the circumference of the bone flap, increased intracranial pressure due to brain swelling and fluid collection, and external shock during postoperative patient management are thought to be the causes of bone flap dislocation. To our knowledge, this is the second reported case of craniotomy with a Craniofix® clamp release.