Grossly Depressed Frontal Bone Fracture in a Paediatric Patient: A Case Report
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CASE REPORT
Grossly Depressed Frontal Bone Fracture in a Paediatric Patient: A Case Report Venkatesh Anehosur1 • M. S. Sahana1 • Niranjan Kumar2
Received: 16 August 2020 / Accepted: 25 September 2020 Ó The Association of Oral and Maxillofacial Surgeons of India 2020
Abstract This study highlights the management of a grossly depressed frontal bone fracture with obvious deformity in a paediatric patient as facial fracture management is frequently intricate and challenging, particularly within the paediatric population as compared to adult. Paediatric fractures have a greater capacity to remodel, but the paediatric brain and craniofacial skeleton are still developing which puts the children at risk for unique complications, such as growing skull fractures. Keywords Depressed frontal bone fracture Paediatric population Titanium mesh
Introduction Head injury and facial trauma are proportional depending upon the extent of the impact of injury. Although various factors play an important role like mechanism of injury which varies from regions, socioeconomic status, and literacy, it is a common cause for deformities and left untreated can cause morbidity and mortality in the paediatric population. The differences between adult and paediatric group is well documented like frontal sinus & Venkatesh Anehosur [email protected] 1
Department of Oral and Maxillofacial Surgery, SDM Craniofacial Research Centre, SDM College of Dental Sciences and Hospital, Shri Dharmasthala Manjunatheswar University, Dharwad, Karnataka 580009, India
2
Department of Plastic and Reconstructive Surgery, SDM Craniofacial Research Centre, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheswar University, Dharwad, Karnataka 580009, India
transforms to adult architecture at the age of 20 years, before that children usually possess large forehead with potential fat pads, elasticity of bone and higher ability to remodel, but the paediatric brain and craniofacial skeleton are in a developing stage that will jeopardize children. Even though paediatric head trauma has been discursively studied, the literature concerning skull fractures, the time of operative management, and outcomes following surgical intervention in this population is very scanty [1]. The ratio between cranial and facial volume at birth is around 8:1. But, as the child grows to the time adulthood, this ratio becomes 2.5:1. The retrusiveness of the face in relation to the skull promotes a lesser occurrence of midface and mandibular fractures and an increased occurrence of cranial injuries in children who are aged below 5 years, especially the frontal bone with its bony prominence [2]. The incidence of depressed skull fractures is seen in 7–10% of children who are admitted to hospital with a head injury. The extent of the head injury may be associated with dural tears, penetration of brain parenchyma with a foreign object or bone fragment, and the presence of primary brain injury or intracranial haematoma. The most imperative complications are post-trauma
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