OPEN COMMINUTED EXPRESSED - DEPRESSED SKULL FRACTURE

Boban Jelenković,Vesna Nikolov,Predrag Milošević,Slavko Živković,Luka Berilažić

doi:10.5633/amm.2018.0413

Abstract

Skull fractures occur as the result of the effect of kinetic forces and represent discontinuity of the bones of the skull. They can be opened and closed affecting tissues; linear, diastatic, comminuted affecting cranial level; or depressed ones often leading to injuries of meninx, brain tissue with different types of intracranial bleeding. The paper presents a 56-year old male patient who suffered severe craniocerebral injury of the frontal region including orbit while operating the wood processing machine. The injury manifested as scalp damage, expressed-depressed open fracture of frontal-orbital region with cerebrospinal fluid leak. Computerized tomography of the brain showed the presence of epidural, subdural, and intracerebral hematoma with mass effect. The injuries were surgically treated, hematomas evacuated, and skull defect was reconstructed by previous plasticizing the dura in order to stop cerebrospinal fluid leak In the reconstruction of the multifragmentary fracture, a star titanium implant was used, but significant implantation of artificial material was not performed due to already contaminated wound and the possibility of a subsequent infection.

Highlights

The size of the contact surface of the mechanical force impact on the skull larger or smaller than 5 cm2 determines the type of fracture and often leads to different intracranial lesions [1, 2]
They are classified as fractures of the epicranium including linear, diastatic fractures, cominuted and limultilinear, as well as depressed skull base fractures
Prompt and adequate surgery of open skull fractures with evident intracranial complications is of vital importance to the patient

Summary

Case report

Skull fractures occur as the result of the effect of kinetic forces and represent discontinuity of the bones of the skull. They can be opened and closed affecting tissues; linear, diastatic, comminuted affecting cranial level; or depressed ones often leading to injuries of meninx, brain tissue with different types of intracranial bleeding. The injury manifested as scalp damage, expressed-depressed open fracture of frontal-orbital region with cerebrospinal fluid leak. The injuries were surgically treated, hematomas evacuated, and skull defect was reconstructed by previous plasticizing the dura in order to stop cerebrospinal fluid leak In the reconstruction of the multifragmentary fracture, a star titanium implant was used, but significant implantation of artificial material was not performed due to already contaminated wound and the possibility of a subsequent infection

Introduction

Conclusion

Findings

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