Surgical management of depressed cranial fractures.

M. Ross Bullock, Randall Chesnut, Jamshid Ghajar, David Gordon, Roger Hartl, David W. Newell, Franco Servadei, Beverly C. Walters, Jack Wilberger

Research output: Contribution to journalReview article

49 Scopus citations

Abstract

INDICATIONS: Patients with open (compound) cranial fractures depressed greater than the thickness of the cranium should undergo operative intervention to prevent infection. Patients with open (compound) depressed cranial fractures may be treated nonoperatively if there is no clinical or radiographic evidence of dural penetration, significant intracranial hematoma, depression greater than 1 cm, frontal sinus involvement, gross cosmetic deformity, wound infection, pneumocephalus, or gross wound contamination. Nonoperative management of closed (simple) depressed cranial fractures is a treatment option. TIMING: Early operation is recommended to reduce the incidence of infection. METHODS: Elevation and debridement is recommended as the surgical method of choice. Primary bone fragment replacement is a surgical option in the absence of wound infection at the time of surgery.All management strategies for open (compound) depressed fractures should include antibiotics.

Original languageEnglish (US)
Pages (from-to)S56-60; discussion Si-iv
JournalNeurosurgery
Volume58
Issue number3 Suppl
StatePublished - Mar 2006

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Bullock, M. R., Chesnut, R., Ghajar, J., Gordon, D., Hartl, R., Newell, D. W., Servadei, F., Walters, B. C., & Wilberger, J. (2006). Surgical management of depressed cranial fractures. Neurosurgery, 58(3 Suppl), S56-60; discussion Si-iv.