Abstract:
Objective We present our experience in the management of frontal bone fractures using the previously described radiologic classification of frontal bone fractures. Methodology A retrospective study was conducted, which reviewed the medical records and computed tomographic (CT) scan images of patients with frontal bone fracture from January 2016 to February 2019. Patients with complete medical records and a follow-up of minimum 1 year were included in the study. Demographic details, mechanism of injury, associated intracranial injuries, maxillofacial fractures, management, and complications were analyzed. CT scan images were used to classify the frontal bone fractures using the novel classification given by Garg et al (2014). The indications for surgical treatment were inner table frontal sinus fracture with cerebrospinal fluid (CSF) leak, intracranial hematoma with significant mass effect requiring surgical evacuation, and outer table comminuted fracture that is either causing nasofrontal duct obstruction or for cosmetic purpose. Results A total of 55 patients were included in the study. Road traffic accidents as the commonest cause of frontal bone fractures. The most common fracture pattern was type 1 followed by type 5 and depth B followed by depth A. Four patients presented with CSF rhinorrhea. CSF rhinorrhea was more frequent with fracture extension to the skull base (depth B, C, D), which was statistically significant ( p < 0.001). Conclusion Frontal bone fracture management has to be tailor-made for each patient based on the extent of the fracture, presence of CSF leak, and associated intracranial and maxillofacial injuries.
摘要:
目的我们介绍使用先前描述的额骨骨折的放射学分类来治疗额骨骨折的经验。方法进行了一项回顾性研究,回顾了2016年1月至2019年2月额骨骨折患者的病历和计算机断层扫描(CT)扫描图像。该研究包括具有完整医疗记录和至少1年随访的患者。人口统计细节,损伤机制,相关的颅内损伤,颌面部骨折,管理,并对并发症进行分析。CT扫描图像用于使用Garg等人(2014)给出的新分类对额骨骨折进行分类。手术治疗的适应症为内台额窦骨折伴脑脊液(CSF)漏,颅内血肿具有明显的质量效应,需要手术疏散,和外表粉碎性骨折,导致鼻额管阻塞或用于美容目的。结果共纳入55例患者。道路交通事故是额骨骨折的最常见原因。最常见的骨折类型是1型,其次是5型,深度B其次是深度A。四名患者出现CSF鼻漏。脑脊液鼻漏更常见,骨折延伸至颅底(深度B,C,D),具有统计学意义(p<0.001)。结论额骨骨折的处理必须根据骨折的范围为每位患者量身定制,CSF泄漏的存在,以及相关的颅内和颌面部损伤。