Abstract: The disclosed cranial flap clamp includes first and second clamping members and an extension member. A portion of the first member is positionable against inferior surfaces of a bone flap and skull and a portion of the second member is positionable against superior surfaces of the flap and skull. The extension member extends from the first member through the second member and fits between the flap and skull. Movement of either of the clamping members urges the inner surface of the first member against the inferior surfaces of the flap and skull and urges the inner surface of the second member against the superior surfaces of the flap and skull. The securing instrument includes features useful in cutting or crimping the extension member. The tension limiting assembly provides variable designs and combinations for limiting the tension placed on, and exerted by, the securing instrument during use.