Growing Skull Fracture and the Orbitocranial Variant: Nuances of Surgical Management
- Resource Type
- Authors
- Bhagavatula Indira Devi; Vikram Singh; Dhananjaya I Bhat; Gopalakrishnan M Sasidharan
- Source
- Pediatric Neurosurgery. 52:161-167
- Subject
- Male
medicine.medical_specialty
medicine.medical_treatment
03 medical and health sciences
0302 clinical medicine
Skull fracture
Surgical site
medicine
Craniocerebral Trauma
Humans
Retrospective Studies
Skull Fractures
business.industry
Postoperative complication
General Medicine
Autologous bone
medicine.disease
Cranioplasty
Surgery
medicine.anatomical_structure
Child, Preschool
030220 oncology & carcinogenesis
Scalp
Pediatrics, Perinatology and Child Health
Female
Dura Mater
Neurology (clinical)
Complication
business
030217 neurology & neurosurgery
Orbit (anatomy)
- Language
- ISSN
- 1423-0305
1016-2291
Aims: Growing skull fracture (GSF) is a rare complication resulting from diastatic enlargement of a pediatric skull fracture. Orbitocranial GSF is a distinct variant with more complex management issues due to the displacement of the globe. This study aims to discuss surgical considerations in the management of GSF, with particular reference to orbitocranial variants. Methods: We conducted a retrospective analysis of 7 children operated for GSFs at our institute from 2008 to 2015. Results: Four boys and 3 girls were operated during this period. The mean age at initial trauma was 2 years, and most of them sustained falls. The most frequent symptoms of GSF were progressive scalp swelling and proptosis. The most common location was the orbitofrontal region. Duraplasty with cranioplasty was performed in 5 patients, while duraplasty alone was only required in 2 patients. A postoperative complication was noted in 1 patient and managed successfully. Good cosmetic results were obtained in all of the cases. Conclusions: Duraplasty is essential in the repair of GSF and should be followed by cranioplasty to prevent recurrent leptomeningeal herniation. We recommend the use of autologous bone from the surgical site for cranioplasty. Orbital roof repair is advisable for good visual and cosmetic outcome in orbitocranial variants of GSF.