Background: Traditionally,
surgical management of compound depressed calvarial fractures entails elevation
and removal of all bone fragments with delayed cranioplastic repair of the
defect. Objective: To assess the advantages and disadvantages of
early one stage elevation, debridement and plastic repair of compound depressed
fractures. Methods: 25 patients with ages ranging from4 to 47 years were
included. All patients were treated for compound calvarial fractures by early
one stage elevation, debridement and cranioplastic repair to assess the
advantages and disadvantages of the early cranioplastic repair. Results: only
two patients showed early post-operative signs of superficial wound infection
that were adequately controlled by local wound care and systemic antimicrobial
therapy and after an average follow up of 6.5 months no cases of infection
necessitating re-operation or prolonged antimicrobial therapy were encountered.
Conclusion: Early single stage elevation, debridement and cranioplastic repair
of compound calvarial fractures is a valid treatment scenario that can be
adopted whenever possible with no added risk of infection. [Egypt J Neurol Psychiat
Neurosurg. 2011; 48(4): 325-329]
Key Words: Head
injury, calvarial fractures, cranioplastic repair.
Correspondence to Ahmad Elayouty, Department of
Neurosurgery, Ain Shams University,
Egypt.
Tel.:
+20101599210. Email: dr.ahmad_elsayed@med.asu.edu.eg