Fullarton G M, MacEwen C J, MacMillan R, Swann I J
Arch Emerg Med. 1987 Mar;4(1):11-6. doi: 10.1136/emj.4.1.11.
A retrospective study of 661 adult patients with open scalp wounds attending the Accident and Emergency Department of Glasgow Royal Infirmary, Glasgow, Scotland, was performed. Detailed information was recorded about history, nature of open wounds ('contused' or 'incised'), wound exploration and radiological findings. The commonest cause of injury was assault (40%), followed by falls (34%). Half of the patients had been drinking alcohol. The majority of scalp wounds were 'contused' (84%) resulting equally from assaults and falls; 'incised' wounds (16%) were more commonly due to assault. Although division of the occipitofrontalis aponeurosis was infrequent (18%), most (78%) of the skull fractures occurred in this group. Wound exploration detected nine fractures not evident on skull X-rays. To maximise fracture detection rate, careful wound exploration should be an important adjunct to skull radiography and, in particular, division of the occipitofrontalis aponeurosis should alert the casualty officer to the likelihood of a skull fracture.
对661例就诊于苏格兰格拉斯哥皇家医院急诊科的成年开放性头皮损伤患者进行了一项回顾性研究。记录了有关病史、开放性伤口性质（“挫伤”或“切割伤”）、伤口探查及影像学检查结果的详细信息。最常见的致伤原因是袭击（40%），其次是跌倒（34%）。半数患者受伤时饮酒。大多数头皮伤口为“挫伤”（84%），由袭击和跌倒所致的比例相同；“切割伤”（16%）更常见于袭击所致。尽管枕额肌腱膜断裂不常见（18%），但该组中大多数颅骨骨折（78%）发生于此。伤口探查发现9例颅骨X线片未显示的骨折。为提高骨折检出率，仔细的伤口探查应作为颅骨X线检查的重要辅助手段，尤其是枕额肌腱膜断裂应提醒急诊医生注意存在颅骨骨折的可能性。
