Abstract

ABSTRACT Background: Many changes and improvements have taken place in the management of patients with head injury in the past 20 years. The introduction of the Advanced Trauma Life Support (ATLS) training program, which started in 1980, helped in better understanding of management of trauma patient. By preventing injury, limiting trauma, and treating early, we can achieve good outcome in patients with head injury. Aims and Objectives: To study the various associated intracranial injury with depressed skull fracture (DSF) and to establish a plan of management of DSF.
Materials and Methods: This prospective study was undertaken on 50 patients with DFS visiting Department of Surgery at Sir Sayajirao General Hospital and Medical College, Baroda, from January 2010 to March 2012. The patients selected for this study belonged to all age groups and had clinically palpable DSF. The CT scan showed DFS. The principles of management were conservative as well as operative, depending on the type of fracture.
Results: Out of 50 patients, 32% were aged between 21 and 30 years; 94% were men and 6% were women. Vehicular accidents were the cause in 30 (60%) patients, whereas 8 (16%) patients witnessed assault. Extradural hematoma was reported in two (11.11%) patients. Of 42 cases of mild head injury, 29 were managed conservatively and 13 were operated. Six cases had severe head injury; three were operated; and three were treated conservatively. Conclusion: Early definitive diagnosis and management of skull fracture decrease morbidity and mortality as well as help achieving maximal functional and aesthetic rehabilitation.