Adeolu Augustine Abiodun, Shokunbi Matthew Temitayo, Malomo Adefolarin Obanisola, Komolafe Edward Oluwole, Olateju Samuel Oluremi, Amusa Yemisi Bola
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria 20001.
Surg Neurol. 2006 May;65(5):503-5. doi: 10.1016/j.surneu.2005.07.010.
We report 4 patients who presented with a rare type of vault fracture. This form of fracture has only been described in few instances in the literature.
All the patients presented with elevation of free skull fracture fragments. The etiologies were assault (1 patient), domestic accident (1 patient), and road traffic accident (2 patients). All the fractures were compound as in previously reported cases. Delay in surgery resulted in cerebral abscess in 1 patient. Surgery was performed in all the patients: wound debrident, duroplasty, and reduction of fracture in 3 patients and craniotomy with excision of abscess in 1 patient. Two of the patients did well after surgery. The patients with abscess died 9 days after surgery. Another patient developed CSF fistula after surgery, and died of aspiration while waiting for the closure of the fistula.
Elevated skull fractures in our series were all compound fractures. Both long, sharp objects as well as blunt objects can cause this injury. Delay in surgery could result in intracranial sepsis. We suggest that this fracture should be included in the classification of skull fractures.
我们报告4例呈现罕见类型颅顶骨折的患者。这种骨折形式在文献中仅有少数病例描述。
所有患者均出现游离颅骨骨折碎片抬高。病因包括袭击（1例）、家庭意外（1例）和道路交通事故（2例）。与先前报道的病例一样，所有骨折均为开放性骨折。1例患者手术延迟导致脑脓肿。所有患者均接受了手术：3例患者进行了伤口清创、硬脑膜成形术和骨折复位，1例患者进行了开颅手术并切除脓肿。2例患者术后恢复良好。脓肿患者术后9天死亡。另1例患者术后出现脑脊液漏，在等待瘘口闭合期间因误吸死亡。
我们系列中的颅骨抬高骨折均为开放性骨折。长而尖锐的物体以及钝器均可导致这种损伤。手术延迟可能导致颅内感染。我们建议这种骨折应纳入颅骨骨折的分类中。
