Depressed fractures in general require surgical management. Functional and or esthetic considerations must be kept in mind. From the functional point of view, decompression of the brain requires acute treatment.
|Non- or minimally displaced fractures not involving the frontal sinus, without CNS or vascular injury, and stable neurological status.|
- No evidence of an intracranial mass lesion (bleeding), CSF leak (CSF rhinorrhea), or increase in intracranial pressure
- Stable neurological status (high Glasgow coma scale GSC)
CAUTION: A linear cranial vault fracture, even if not displaced on computed tomography, may tear the dura (occurring typically in children, e.g., growing fractures).
|Treatment of depressed cranial vault fractures|
|Depressed fractures (decompression of the brain requires acute treatment).|
- Non-displaced fractures located over the frontal sinus that can cause late complications such obstruction or frontal sinus mucocele due to mucous-membrane laceration
Linear cranial vault fracture, even if not displaced on computed tomography, may tear the dura (occurring typically in children, e.g., growing fractures).
Bone fragments can also cause skin lacerations and/or subgaleal hematoma.
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|