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. 2018 Apr-Jun;13(2):341-347.
doi: 10.4103/ajns.AJNS_117_16.

Analysis of Factors Influencing Outcome of Depressed Fracture of Skull

Ritesh S Satardey  1 , Srikant Balasubramaniam  2 , Jayashree S Pandya  1 , Rajesh C Mahey  1
Affiliations

Analysis of Factors Influencing Outcome of Depressed Fracture of Skull

Ritesh S Satardey et al. Asian J Neurosurg. 2018 Apr-Jun.

Abstract

Context: The outcome of patients with depressed fracture varies and depends on multiple factors. There has been no previous study on the significance of these factors on the outcome of depressed fracture of the skull and hence this study. Aims: The primary aim of our study is to find the factors affecting the outcome in cases of depressed skull fracture (DSF). This will help us improve outcomes and give more accurate prediction of long-term outcomes.

Settings and design: Prospective observational study.

Subjects and methods: Institutional Ethics Committee approval was taken for doing this observational study. This was conducted in a tertiary care institute by collecting data of fifty cases of DSFs in 2 years, between January 2012 and December 2013. The study included patients who were diagnosed with DSFs admitted to our tertiary care public hospital. Patients with comorbidity involving injury to other organs or medical disorders and pediatric patients were excluded from our study.

Statistical analysis used: Chi-square test and Fisher exact test. Results: There was a statistically significant impact on age, sex, Glasgow Coma Scale (GCS) score at presentation, type of DSF, and site of DSF in the long-term outcome of patients. The patients with GCS score of 13 or more fared well with good long-term outcome as against those with GCS score below it. Any additional brain injury in the form of hematomas, etc., has a significant negative impact on long-term outcome of the patient and warrant urgent surgical intervention. Complications such as dural tear, cerebral contusions, wound infections, and seizures have adverse effect on the recovery.

Conclusions: Our observation suggests that patients brought to hospital with minimal delay, with GCS score between 13 and 15, with simple DSF and normal brain parenchyma without dural tear, have the best outcome.

Keywords: Depressed skull fracture; factors influencing outcome in skull fracture; outcome in depressed fracture of skull.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Intraoperative picture of a depressed fracture near the midline. Burr holes have been placed near the depressed segment to elevate it
Figure 2
Figure 2
Graphical representation on mode of management of patients in our series
Figure 3
Figure 3
Computerized tomography scan bone window showing depressed fracture or right frontal bone
Figure 4
Figure 4
Axial plain computerized tomography image showing postoperative changes with resolution of contusion
Figure 5
Figure 5
Axial plain computerized tomography image showing depressed fracture in left posterior parietal bone with underlying contusion
Figure 6
Figure 6
Three-dimensional bar chart showing graphical representation of outcome in our series
Figure 7
Figure 7
Graphical representation of complications seen in our series
See this image and copyright information in PMC

References

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