It Is Time to Reduce Free-Hand Manipulation: Case Report of Our Proposal for an Innovative 1-Step Cranioplasty.

Background: Cranioplasty is a well-known procedure, and autologous graft bone is usually considered the best choice in this procedure, but it cannot be used in conditions such as bone-infiltrating tumors, spheno-orbital en plaque meningiomas, and bone infections. Polymethylmethacrylate (PMMA) offers great possibility of intraoperative adaption. We describe a case of 1-step cranioplasty performed in a patient with a meningeal fibrosarcoma using a custom-made silicon mold.

Surgical results of cranioplasty with a polymethylmethacrylate customized cranial implant in pediatric patients: a single-center experience.

OBJECTIVE Cranioplasty is a reconstructive procedure used to restore skull anatomy and repair skull defects. Optimal skull reconstruction is a challenge for neurosurgeons, and the strategy used to achieve the best result remains a topic of debate, especially in pediatric patients for whom the continuing skull growth makes the choice of material more difficult. When the native bone flap, which is universally accepted as the preferred option in pediatric patients, is unavailable, the authors' choice of prosthetic material is a polymethylmethacrylate (PMMA) implant designed using a custom-made technique.

A new design of a Nitinol ring-like wire for suturing in deep surgical field.

The present work proposes a new suturing procedure based on self-accommodating suture points. Each suture point is made of a commercial NiTi wire hot-shaped in a single loop ring; a standard suture needle is then fixed at one end of the NiTi suture. According to this simple geometry, several NiTi suture stitches have been prepared and tested by tensile test to verify the closing force in comparison to that of commercial sutures.

Design and thermo-mechanical analysis of a new NiTi shape memory alloy fixing clip.

In this work, a new NiTi shape memory alloy (SMA) bone fixator is proposed. Thanks to the shape memory effect, this device does not need any external tool for the fixation, as the anchorage is obtained only by the self-accommodation of the clip during the parent transformation. Calorimetry and thermo-mechanical tests were used to evaluate the phase transformation temperatures and to estimate the forces generated both during the fixing surgical procedure and after the surgical operation.

A finite element model of the L4-L5 spinal motion segment: biomechanical compatibility of an interspinous device.

The biomechanical compatibility of an interspinous device, used for the "dynamic stabilization" of a diseased spinal motion segment, was investigated. The behaviour of an implant made of titanium based alloy (Ti6Al4V) and that of an implant made of a super-elastic alloy (Ni-Ti) have been compared. The assessment of the biomechanical compatibility was achieved by means of the finite element method, in which suitable constitutive laws have been adopted for the annulus fibrosus and for the metal alloys.