Prevention of halo pin complications in post-cranioplasty patients.

Introduction: Distraction Osteogenesis has been successfully implemented in the treatment of maxillary hypoplasia. By using the Rigid External Distraction device (RED) the maxilla can be advanced without the need for bone grafts, providing more stability to the repositioned maxilla.

Background: The introduction of the RED system in craniofacial surgery has given rise to previously unseen problems.

Aim: To provide a set of protocol improvements that might prevent the intracranial pin migration seen at the removal of a RED-II in one patient.

Conclusions: Although the RED device has been shown to achieve good clinical results, there are some disadvantages to the system. There is a high incidence of pin tract infections - leading to loosening of the pins and loss of rigidity. Also, the external ring is prone to traumatic injury. Furthermore, the positioning of the pins can be difficult in thin bone. The improvements used in our protocol might prevent this complication.