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A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma.If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain.
The skull can be fractured, but not necessarily. A penetrating head injury occurs when an object pierces the skull and breaches the dura mater. Brain injuries may be diffuse, occurring over a wide area, or focal, located in a small, specific area. A head injury may cause skull fracture, which may or may not be associated with injury to the ...
The Le Fort III fracture (transverse fracture) occurs at the level of the skull base, resulting in complete craniofacial separation of the midface from the base of the skull. [ 2 ] [ 3 ] The fracture line extends through the zygomatic arch , the pterygoid plates , the lateral and medial orbital walls , the nasal bones , and the nasal septum .
Fractures with displacement require surgery consisting of fracture reduction with miniplates, microplates and screws. Gillie's approach is used for depressed zygomatic fractures. [5] The prognosis of tripod fractures is generally good. In some cases there may be persistent post-surgical facial asymmetry, which can require further treatment. [6]
Skull x-ray or CT scanning is used if neurological symptoms appear. These measurements are also used if concomitant depressed skull fracture is a possibility. Usual management is mainly observation. Phototherapy may be necessary if blood accumulation is significant leading to jaundice. Rarely, anaemia can develop needing blood transfusion.
In case of head injury, a dural tear is likely in case of a depressed skull fracture. A burr hole is made through the normal skull near the fractured portion, and Adson's elevator is introduced. Underlying dura is separated carefully from the overlying depressed bone fragments.
CSF rhinorrhoea may be a sign of a basilar skull fracture. Other signs of a basilar skull fracture include CSF otorrhea (drainage of CSF through the ear ). [ 2 ] It can have devastating complications in some patients, as the communication between the nasal cavity, the cerebrospinal fluid and the central nervous system can result in severe ...
A penetrating head injury, or open head injury, is a head injury in which the dura mater, the outer layer of the meninges, is breached. [1] Penetrating injury can be caused by high-velocity projectiles or objects of lower velocity such as knives, or bone fragments from a skull fracture that are driven into the brain.