Spanio S (1), Ashammakhi N (2), Ilomäki J (3), Välimaa T (3), Rainer C (1), Waris T (4), Törmälä P (5), and Ninkovic M (1).

1. Department of Plastic Surgery, Innsbruck University, Innsbruck, Austria
2. Division of Plastic Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland
3. Bionx Implants Ltd., Tampere, Finland
4. Division of Plastic Surgery, Department of Surgery, Tampere University Hospital, and University of Tampere, Tampere, Finland
5. Institute of Biomaterials, Tampere University of Technology, Tampere, Finland

Abstract
A new device (a tack-shooter) to apply bioabsorbable tacks in craniofacial surgery has been developed. This new device was used in 15 children, who underwent various cranioplasty procedures, to demonstrate its reliability and simple technical application in cranial bone osteofixation. Bone segments were fixed together and to the cranial bones, using Biosorb plates and tacks. Stable and secure fixation was obtained intra-operatively, with reduced operative time (10-15%) compared with earlier use of plates and screws. However, its use in very thin bone (less than 1 mm thick) is very limited because of bone fragility. In conclusion, use of tacks and a tack-shooter reduces operative time, risk of infection and blood loss, and consequently costs. It is therefore very useful in selected craniofacial cases.

Key words
Bioabsorbable, Craniofacial, Cranioplasty, Tack, Tack-shooter