Abstract:Objective To study the techniques of cranial flap fixation (suture.stainless steel wire and rivet-like titanium clamp). Methods 24 cadaver craniotomy flaps were divided into three groups, then every eight flaps were reattached with sutures.stainless steel wires and rivet-like titanium clamps respectively. Bone flap fixation was timed and measured for offset with craniotomied skull for every fixation technique, load-bearing tests were performed by applying an external force until failure of the fixation system. The results were compared. Results Rivet-like titanium clamp required signifi cantly less time (94±13)s to fix than either suture (172±14)s or stainless steel wire (399±45)s. Rivet-like titanium clamp also showed significantly smaller offset (0.20±0.12)mm than either suture (2.20±0.24)mm or stainless steel wire (1.32±0.34)mm. Rivet-like titanium clamp was stronger than suture and stainless steel wire. Conclusion Rivet-like titanium clamp is ease to use, require less time consumption, and show accuracy and strength.