Despite lack of underlying associated brain injury this fracture required operative debridement and elevation of the bone fragments.
The level of depression is greater than the bony table and there are a number of bone fragments impacted below the inner cortex of the opposing bone (large arrow). Note the associated pneumocephalus (small arrows). : Sagittal CT images of an open, comminuted, depressed skull fracture. Note the air in the soft tissues (small arrow), the small amount of pneumocephalus associated with the fracture (circle), and that the level of elevation of the bone fragment is significantly more than the thickness of the bony table From the teaching collection of Demetrios Demetriades used with permission. : Axial CT scan demonstrating open elevated linear skull fracture (large arrow). : Depressed skull fracture: level of depression equal to thickness of cortex From the teaching collection of Demetrios Demetriades used with permission. : Comminuted depressed fracture of the frontal sinus with air, fluid, and bone fragments in frontal sinus and pneumocephalus level of depression greater than width of cortex From the teaching collection of Demetrios Demetriades used with permission. : Comminuted depressed skull fracture with pneumocephalus From the teaching collection of Demetrios Demetriades used with permission.
: Comminuted nondepressed fracture From the teaching collection of Demetrios Demetriades used with permission. This injury pattern is concerning for associated spinal fracture, cord injury, and blunt cerebrovascular injury From the teaching collection of Demetrios Demetriades used with permission. : Axial CT scan showing nondepressed linear skull fracture (arrow) of the skull base involving the foramen magnum. : Axial CT scan demonstrating an open nondepressed linear skull fracture (arrow) associated with pneumocephalus (circle) From the teaching collection of Demetrios Demetriades used with permission. : Linear parietal fracture without depression From the teaching collection of Demetrios Demetriades used with permission. Skull fractures may be linear or comminuted comminuted fractures are complex with multiple fracture lines.
COMMINUTED FRACTURE COMMON LOCATION SKIN
Open fractures communicate with the skin through a wound, a sinus, the ear, or the oropharynx. Skull fractures are categorized according to the appearance, location, degree of depression, and if they are open or closed. Skull fracture refers to a fracture of one or more bones of the cranial vault or skull base.
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