Epidemiological and Therapeutic Aspects of Depressed Skull Fractures

Abstract

Objective:  To describe the epidemiological, clinical, therapeutic, and evolutionary characteristics of depressed skull fractures in our hospital.

Materials and Methods:  This was a 15-month prospective descriptive study involving all patients operated on for a depressed skull fracture. Recruitment was carried out after obtaining the consent of the patient or the person accompanying him/her. The clinical diagnosis was confirmed by a cerebral CT scan.

Results:  During the study period, depressed skull fractures accounted for 16% of head injuries. The average age of the patients was 27 years. Males predominated (66.7%). Apprentice motorbike mechanics were the most affected with 20.4%, followed by students with 18.5%. Road traffic accidents and intentional assault and battery were the main causes of trauma, with 37.9% and 29.6% respectively. Headache was present in all patients admitted to emergency departments, followed by scalp wounds (63.5%) and hemiparesis (45.9%). Cerebral CT scans revealed an open embracing fracture in 63 patients (58.3%). Ping-Pong ball fractures were found in 11.1%. 42.6% of patients had associated intracranial lesions. Surgery was performed through a single trepan hole in 49% of patients. A craniotomy with bone flap replacement was performed in 34.3%. At 6 months, 77.3% of patients had a favorable outcome; 16.5% had a persistent motor deficit and 3.1% of patients were taking anti-epileptic drugs. Mortality was 2.06%.

Conclusion:  Depressed skull fractures are pathologies that are sometimes considered trivial, even though they are responsible for significant disability. Emphasis must be placed on prevention to achieve better results.