Compound Elevated Skull Fracture Presented as a New Variety of Fracture with Inimitable Entity: Single Institution Experience of 10 Cases.

Abstract

Background:Compound elevated Skull fracture (CESF) is a rare variety of fracture with rare presentation in comparison to other type of skull fracture. The mechanical force being applied is tangential causing high impact over skull as comparison to structure underlying the cranium.Objective:Aims of this study are bring attentiveness and management to deal this rare type of fracture and its outcomes.Materials and Methods:In this study, we demonstrated 10 cases of CESF in adult patients from January 2014 to January 2018 in the Department of Neurosurgery at RNT Medical College and M. B. Hospital, Udaipur, Rajasthan, India. Recorded documents were prospectively studied for age of distribution, sex, mode of injury, mechanism of injury, clinical profile, radiological investigations, neurosurgical management, and outcome asses by Glasgow outcome scale.Results:Totally 10 patients had CESF. Six are males and four are females. Male to female ratio was 3:2. Their age range was 20–45 years. The most common mode of injury was Road traffic accident in 60%. Wound exploration, cleaning, debridement, and reduction of fracture segment was done in eight cases, frontal bone craniotomy with evacuation of pneumocephalus done one case, frontal bone craniotomy, and extradural hematoma evacuation was done in one case. The postoperative course was uneventful, and outcome was good (GOS 5) in 8 (80%) cases.Conclusion:In compound elevated fracture, early recognition and immediate surgical intervention should be done to avoid related morbidity and mortality. Any delay in surgery may lead to a high possibility of wound infection and poor outcome.