Aims: Aim is to study the presentation and management of patients with depressed skull fractures at DHQ Teaching Hospital/Sahiwal Medical College Sahiwal.
Materials and Methods: Elevation and repair of an open depressed skull fracture is often of as an emergency procedure. Common indications for emergency elevation of depressed skull fracture have been Dural tear, gross contamination, mass affect from depressed bone and/or sizable underlying extradural collection. Surgery may be performed if patient gets seizures and develops depression of skull especially frontal region which needs surgery for cosmetic reasons. Over a period of four years one hundred patients with depressed skull fractures were admitted in Neurosurgery department from July 2011 to June 2015.Mode of injury, clinical presentation, site and side of depressed skull fracture were noted. X-skull and C T scan brain was done in all cases to confirm the diagnosis and to see the underlying brain injury.
Results: Pre-operative GCS score was from 6 – 15. Focal neurological deficit was present in 16 cases. Surgical management done was wound debridement, elevation of depressed bone pieces, repair of Dura and evacuation of underlying hematoma. Fourteen patients developed different complications which were managed successfully.
Conclusion: Depressed skull fracture is a neurosurgical emergency which needs early operation to reduce the incidence of infection. Wound wash, debridement and elevation of depress fragment is treatment of choice along with Dural repair and/or evacuation of underlying hematoma as/if needed
