Pediatric depressed skull fractures: analysis of 530 cases
| Autor: | Saffet Mutluer, I. Palali, Yusuf Erşahin, Hasan Mirzai |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Intracranial hematoma Brain Abscess Poison control Wounds Penetrating Wounds Nonpenetrating Central nervous system disease Age Distribution Skull fracture Seizures medicine Humans Sex Distribution Child Brain Diseases Skull Fractures business.industry Head injury Infant Newborn Infant Electroencephalography General Medicine medicine.disease Surgery Skull Treatment Outcome medicine.anatomical_structure El Niño Child Preschool Pediatrics Perinatology and Child Health Female Neurology (clinical) Neurosurgery business Follow-Up Studies |
| Zdroj: | Child's Nervous System. 12:323-331 |
| ISSN: | 1433-0350 0256-7040 |
| DOI: | 10.1007/bf00301021 |
| Popis: | Depressed skull fractures (DSFs) account for 7-10% of children admitted to hospital with a head injury and 15-25% of children with skull fractures. We reviewed the records of 530 patients operated on for DSF from January 1, 1973, to December 31, 1993. This group was made up of 357 boys (67%) and 173 girls (33%) whose ages ranged from 1 day to 16 years (mean age 6.1 years). Fall was the most common cause of injury. Of the 530 patients with DSF, 66% had compound fractures. The incidence of compound fractures increased with age. Compound fractures caused more brain lacerations (29%) than simple fractures (15.5%) did. We also classified DSFs radiologically as true, flat, or ping-pong ball fractures. Associated intracranial lesions were found to be a bad prognostic factor. There were 13 deaths (2.5%) in this series. Satisfactory results were achieved in over 95% of the patients. Compound fractures are associated with a worse outcome and a higher incidence of intracranial lesions and cortical laceration. Unilateral pupillary dilatation and an admission GCS score of 8 or less are ominous signs in regard to mortality. We also found that the deeper the depressed bone, the higher the risk of both dural tear and cortical laceration and the worse the prognosis. A conservative approach should be followed in cases of simple DSF without associated intracranial hematoma and in cases in which the bone depression is not deeper than 1 cm. |
| Databáze: | OpenAIRE |
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