• Aleksander M Vitali and Paul Steinbok.
• Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital, Children's and Women's Health Centre, Vancouver, British Columbia, Canada.
• Childs Nerv Syst. 2008 Aug 1;24(8):917-23; discussion 925.

ObjectiveA head fixation device with pins is commonly used for immobilization of the patient's head during craniotomy. The safety of head fixation devices in children has been discussed rarely in the literature. The purpose of this report is to review our experience with complications of head fixation with pins in children undergoing craniotomies and to review the literature on this subject.Materials And MethodsThe database of the Division of Neurosurgery was reviewed to identify children who had cranial complications related to the use of a pin head fixation device. The charts of these patients were reviewed retrospectively.ResultsFive of 766 children (0.65%) undergoing craniotomies with pin fixation of the head had depressed skull fractures and/or epidural hematomas from the pin fixation. Age ranged from 2.6 to 7.5 years; all fractures were temporal and occurred during posterior fossa craniotomies.ConclusionsDepressed skull fractures and associated epidural hematomas need to be considered as possible complications of pin fixation of the head for craniotomy in young children.

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