From the Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.
Driscoll Children's Hospital, Corpus Christi, TX.
Pediatr Emerg Care. 2021 Apr 1;37(4):213-217. doi: 10.1097/PEC.0000000000002215.
Skull fractures are commonly seen after both accidental and nonaccidental head injuries in young children. A history of recent trauma may be lacking in either an accidental or nonaccidental head injury event. Furthermore, skull fractures do not offer an indication of the stage of healing on radiologic studies because they do not heal with callus formation as seen with long bone fractures. Thus, a better understanding on the timing of skull fracture resolution may provide guidance on the medical evaluation for accidental or nonaccidental head injury.
The aim of the study was to determine the time required for radiographic skull fracture resolution in children younger than 24 months.
This was a retrospective observational analysis of children younger than 24 months referred with skull fractures between January 2008 and December 2012. Analysis included children with accidental head injuries with a known time interval since injury and a negative skeletal survey who underwent serial radiographic studies. Complete healing of a skull fracture was defined as resolution of fracture lucency by radiograph.
Of the 26 children who met inclusion criteria, 11 (42.3%) demonstrated resolution of skull fracture(s) on follow-up imaging. Fracture resolution on radiologic studies ranged from 2 to 18 weeks. Twelve fractures in 10 children demonstrated fracture resolution at 10 or more weeks after injury.
Healing or resolution of a skull fracture can take months in children younger than 24 months. With the high variability in skull fracture presentation and large window to fracture resolution, unexplained or multiple skull fractures in children younger than 24 months may be the result of a single or multiple events of head trauma.
颅骨骨折在儿童意外或非意外头部受伤后均较为常见。在意外或非意外头部受伤事件中，近期创伤史可能并不存在。此外，颅骨骨折在影像学研究中不能提供愈合阶段的指示，因为它们不像长骨骨折那样通过骨痂形成愈合。因此，更好地了解颅骨骨折愈合的时间可能有助于指导对意外或非意外头部受伤的医学评估。
本研究旨在确定 24 个月以下儿童放射影像学颅骨骨折愈合所需的时间。
这是一项回顾性观察性分析，纳入了 2008 年 1 月至 2012 年 12 月期间因颅骨骨折就诊且年龄小于 24 个月的儿童。分析包括具有已知受伤时间间隔且骨骼 X 线检查阴性的意外头部受伤儿童，他们接受了系列放射影像学研究。颅骨骨折完全愈合定义为 X 线照片上骨折透亮区消失。
符合纳入标准的 26 名儿童中，11 名（42.3%）在随访影像学检查中显示颅骨骨折愈合。放射影像学研究显示骨折愈合时间从 2 周到 18 周不等。10 名儿童的 12 处骨折在受伤后 10 周或更长时间显示骨折愈合。
24 个月以下儿童的颅骨骨折愈合可能需要数月时间。由于颅骨骨折表现的高度可变性和较大的骨折愈合窗口，24 个月以下儿童不明原因或多发性颅骨骨折可能是单次或多次头部创伤的结果。
