Citation

Lehri SA, Agha SF, Tareen MS, Lehri IA, Goraya AAJ. Medical forum monthly 2008; 19(12): 26-32.

Copyright

(Copyright © 2008)

DOI

unavailable

PMID

unavailable

Abstract

AIM: The aim of the study is to examine the efficacy of a conservative and surgical management of depressed fractures skull. Material and methods: A prospective study of 120 patients with depressed skull fractures treated at Bolan Medical Complex Hospital from December 2003-2007. There were 108 males and 12 females, age range was 12 month to 80 years, and the mean age was 40 years. All patients underwent X-ray and cranial CT scan. Depressed fractures due to missile injuries were excluded from the study.

RESULTS: Object fall on the head was the cause of depressed fracture in 30% of our patients, fall from a height in 19%, road traffic accident in 20%, sports injury in 10%, assault in 19.8% and suicidal attempt in 1.2%. Parietal bone was injured in 44%, frontal bone in 32%, temporal bone in 18% and occipital bone in 6%. Seventy-two percent were compound depressed fractures and 28% were simple depressed fractures. Eighty-four patients were managed conservatively, 56 patients with compound fractures (66.7%) and 28 patients (33.3%) with simple fractures. Significant extra-axial haematoma was the indication for elevation of the fracture in 40% of the surgical group, significant wound contamination, brain tissue and CSF in the wound in 5%, frontal sinus involved in 15%, cosmetic deformity in 25%, fracture on the superior sagittal sinus in 10% and right sided hemiplegia in 5%.

CONCLUSION: our study demonstrates that 70% of patients with depressed skull fractures can be safely managed conservatively without major surgical intervention.

Language: en

Keywords

adolescent; adult; human; child; female; male; aged; head injury; patient safety; traffic accident; suicide attempt; article; major clinical study; assault; falling; computer assisted tomography; prospective study; antibiotic agent; hematoma; conservative treatment; debridement; skull fracture; sport injury; brain tissue; clinical effectiveness; frontal sinus; superior sagittal sinus; fracture fixation; surgical infection; frontal bone; skull radiography; hemiplegia; cranioplasty; Conservative approach; Depressed skull fratures; liquorrhea; occipital bone; Surgical approach; temporal bone; wound irrigation