Scribd Logo
Upload

Welcome to Scribd!

  • 2 views

    Management of Depressed Skull Fractures: Definition and Mechanism

    Uploaded by

    gyt2qrjw8v

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Management of Depressed Skull Fractures: Definition and Mechanism

    Uploaded by

    gyt2qrjw8v
    2 views3 pages

    Original Title

    55C74333

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2 views3 pages

    Management of Depressed Skull Fractures: Definition and Mechanism

    Uploaded by

    gyt2qrjw8v

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Management of Depressed Skull Fractures

    Definition and Mechanism

    • A depressed skull fracture occurs when a bone fragment is


    displaced inward by at least the thickness of the skull.
    • These fractures usually result from high-velocity impacts with
    small objects, like blunt force trauma.

    Associated Risks
    Depressed skull fractures are often compound (open) fractures,
    meaning they create a connection between the external
    environment and the intracranial space, leading to:

    • Infection: Risk of meningitis or osteomyelitis due to bacterial


    entry.
    • Neurological Deficits: Bone fragments can compress brain
    tissue, causing localized neurological impairments.
    • Late-onset Epilepsy: Scarring around the injury site may lead
    to seizures over time.

    Diagnosis

    • Clinical Examination: Inspection and palpation of the scalp


    may reveal the depressed area, and neurological tests help
    identify any deficits.
    • Imaging (CT scan): Essential to assess:
    • The extent of the fracture.
    • Presence of intracranial air (pneumocephalus), indicating a
    dural tear.
    • Associated injuries like hematomas or brain contusions.
    Treatment Overview

    • Antibiotics: Administered to prevent infection due to the open


    nature of the fracture.
    • Surgical Elevation and Exploration: Bone fragments are
    elevated to relieve pressure on the brain, remove any necrotic
    tissue, and repair any dural tears.
    • Anticonvulsants: May be prescribed to reduce the risk of
    seizures, especially when the dura or brain tissue is involved.

    Surgical Procedure

    • Burr Holes: Created in the intact skull to access the depressed


    fragment.
    • Elevation: The displaced bone is gently lifted, and any loose
    fragments or devitalized tissue are removed.
    • Dural Repair: If the dura mater (protective brain covering) is
    torn, it is carefully sutured.

    Special Considerations

    • Fractures involving air sinuses:


    • Treated as open fractures due to bacterial presence in the
    sinuses.
    • Broad-spectrum antibiotics are essential, and surgical
    exploration may be necessary.
    • Fractures near dural venous sinuses:
    • Caution is required since elevating the bone could cause
    severe bleeding.
    • Conservative management with close monitoring might be
    preferred.
    • Pediatric fractures: Depressed skull fractures are more
    common in children, but treatment principles are similar to those
    in adults.

    Postoperative Care

    • Medications:
    • Postoperative antibiotics, pain management, and
    anticonvulsants are standard.
    • Neurological Monitoring: Regular checks for signs of
    complications.
    • Rehabilitation: Depending on the extent of injury, physical
    and cognitive therapy may be required.

    Outcomes

    • Prognosis: Depends on the severity of the injury, the presence


    of additional intracranial injuries, and how quickly treatment is
    provided.
    • Early intervention: Timely surgery and appropriate medical
    care can significantly reduce complications and improve long-
    term outcomes.

    In summary, managing depressed skull fractures requires a multi-


    disciplinary approach, including prompt imaging, surgical repair,
    infection control, and postoperative monitoring to ensure the best
    outcomes.

    You might also like