Management Of Depressed Skull Fracture

Abstract

Background: Head injury is the most serious problem all around the world. Over the last 200 years both surgical and conservative
management have been evolved. Chronological surgical management yields better outcome by decreasing mortality and
morbidity. Wound debridement, repair of dural defect and closure of wound are standard principles in management.
Objective: To study the outcomes of surgical management of depressed skull fracture.
Material and methods: This study was conducted in Shifa Medical center from 1st June 2016 to 30thJune 2019. Clinical features
cause, and computerized tomography (CT) pictures were compiled in proforma. Whenever depressed fracture size exceeded than
5mm, cosmetically disfiguring and fracture over the sinus were operated. All the patients were followed for six months.
Results: Total of 60 patients were included 42 patients (70%) were male and 18(30%) were female. Pediatric population was major
contributor 36 out of 60 patients (ratio60%). 56 patients (93.33%)operated, 4 patients (6.67%) were treated conservatively. These 4
patients(6.67%) had severe head injury and were put on ventilator 32 patients (53.3%)fully recovered, 12 patients (20%) had
moderate disability, 8 patients (13%) had severe disability and 3 patients(4.8%)pass away in this study.
Conclusion: It was found that, depressed skull fracture was mostly common in children. Usage of antibiotic and anticonvulsants
had effective results in term of preventing infection and epilepsy during perioperative period. Initial stage surgical treatment is
exceptionally required where size of fracture exceed 5mm. Outcome depended upon the sternness of injury and existence of
associated intra cerebral lesion.
Key words: surgical management, depressed skull fracture (DSF) and CSF leakage.