目的:颅骨骨折可以通过不同的方法治疗,包括观察,非手术治疗,或手术干预。作者描述了他们在乒乓球颅骨骨折的真空辅助抬高的经验,并评估了与手术结果相关的变量。
方法:作者对2021-2022年奥兰治县儿童医院所有采用真空辅助抬高治疗的乒乓球颅骨骨折进行了回顾性研究。变量包括患者年龄,损伤机制,断裂深度,骨折部位的骨厚度,和高度。
结果:7例患者在不使用麻醉的情况下,在床边接受了乒乓球骨折的真空辅助抬高。出生相关创伤引起的骨折比跌倒引起的骨折更深(p<0.001)。骨折部位的骨厚度在两组之间没有显着差异(2.10mmvs2.16mm,n.s)。7例患者中有6例骨折部位凹陷有明显改善,其中四个显示完全骨折复位,两个显示显着复位。骨折复位程度与骨折深度有一定的相关性,两个最深的骨折未能实现完全复位。年龄似乎与骨折复位有关,在该样本中年龄最大的患者之一中观察到最低的降低。除抽吸部位暂时性轻度肿胀外,任何患者均未观察到并发症。骨折不需要再治疗或手术。
结论:真空辅助仰卧位治疗乒乓球颅骨骨折是一种安全有效的非侵入性治疗选择,可在某些情况下使用。该程序可以在床边安全地完成,并且是相对快速的程序。它避免了开放式手术干预的需要,麻醉,或入院,并能带来出色的结果。
OBJECTIVE: Depressed (\"ping-pong\") skull fractures can be treated by different means, including observation, non-surgical treatments, or surgical intervention. The authors describe their experience with vacuum-assisted elevation of ping-pong skull fractures and evaluate variables associated with surgical outcomes.
METHODS: The authors present a retrospective review of all ping-pong skull fractures treated with vacuum-assisted elevation at the Children\'s Hospital of Orange County in 2021-2022. Variables included patient age, mechanism of injury, fracture depth, bone thickness at the fracture site, and degree of elevation.
RESULTS: Seven patients underwent vacuum-assisted elevation of ping-pong fractures at the bedside without the use of anesthesia. Fractures caused by birth-related trauma were deeper than those caused by falls (p < 0.001). There was no significant difference between groups in bone thickness at the fracture site (2.10 mm vs 2.16 mm, n.s). Six of the seven patients experienced significant improvement in fracture site depression, with four displaying a complete fracture reduction and two displaying a significant reduction. The degree of fracture reduction was modestly related to the depth of fracture, with the two deepest fractures failing to achieve full reduction. Age appeared to be related to fracture reduction, with the lowest reduction observed in one of the oldest patients in this sample. No complications were observed in any patient other than temporary mild swelling at the suction site, and no re-treatment or surgery for the fractures was required.
CONCLUSIONS: Vacuum-assisted elevation of ping-pong skull fractures is a safe and effective noninvasive treatment option for infants that can be used under certain circumstances. The procedure can be done safely at the bedside and is a relatively quick procedure. It avoids the need for open surgical intervention, anesthesia, or hospital admission, and can lead to excellent outcomes.