PDF(Pubmed)
Abstract：
Growing skull fracture (GSF) is an uncommon form of head trauma among young children. In prior research, the majority of GSFs were typically classified based on pathophysiological mechanisms or the duration following injury. However, considering the varying severity of initial trauma and the disparities in the time elapsed between injury and hospital admission among patients, our objective was to devise a clinically useful classification system for GSFs among children, grounded in both clinical presentations and imaging findings, in order to guide clinical diagnosis and treatment decisions. The clinical and imaging data of 23 patients less than 12 years who underwent GSF were retrospectively collected and classified into four types. The clinical and imaging characteristics of the different types were reviewed in detail and statistically analyzed. In all 23 patients, 5 in type I, 7 in type II, 8 in type III, and 3 in type IV. 21/23 (91.3%) were younger than 3 years. Age ≤ 3 years and subscalp fluctuating mass were common in type I-III (P = 0.026, P = 0.005). Fracture width ≥ 4 mm was more common in type II-IV (P = 0.003), while neurological dysfunction mostly occurred in type III and IV (P < 0.001).Skull \"crater-like\" changes were existed in all type IV. 10/12 (83.3%) patients with neurological dysfunction had improved in motor or linguistic function. There was not improved in patients with type IV. GCS in different stage has its unique clinical and imaging characteristics. This classification could help early diagnosis and treatment for GCS, also could improve the prognosis significantly.
摘要：
生长性颅骨骨折（GSF）是幼儿头部创伤的一种罕见形式。在先前的研究中，大多数GSF通常根据病理生理机制或损伤后持续时间进行分类.然而,考虑到初始创伤的严重程度以及患者受伤和入院之间的时间差异，我们的目标是为儿童GSF设计一种临床有用的分类系统，基于临床表现和影像学发现，以指导临床诊断和治疗决策。回顾性收集23例12岁以下接受GSF的患者的临床和影像学资料，并将其分为四种类型。详细回顾了不同类型的临床和影像学特征，并进行了统计学分析。在所有23名患者中，5在I型中，7在II型中，8在III型中，和3在IV型。21/23（91.3%）年龄小于3岁。I-III型患者年龄≤3岁，头皮下肿块波动常见（P=0.026，P=0.005）。骨折宽度≥4mm更常见于II-IV型(P=0.003),而神经功能障碍主要发生在III型和IV型（P<0.001）。所有IV型中都存在头骨“类似火山口”的变化。10/12（83.3％）的神经功能障碍患者的运动或语言功能得到改善。IV型患者没有改善。GCS在不同阶段有其独特的临床和影像学特点。这种分类有助于GCS的早期诊断和治疗。也能明显改善预后。
