Prospective comparison of simple suturing and elevation debridement in compound depressed fractures with no significant mass effect

Mukherjee, Kanchan Kumar; Dhandapani, Sivashanmugam; Sarda, Alok C.; Tripathi, Manjul; Salunke, Pravin; Srinivasan, Anand; Tewari, Manoj Kumar; Mathuriya, S. N.

doi:10.1007/s00701-014-2296-1

Cited by 18 publications

(11 citation statements)

References 15 publications

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“…9,18,20 Craniotomy and elevation of depressed fracture was done in 42% patients. Mukherjee et al 16 had done surgical elevation debridement in 21% patients which is lower than this study whereas study by Braakman 9 who has done surgical intervention in 73 % patients and study by Hossain et al 20 who has performed surgical treatment in 72% patients, which is higher than this study. Highest rate of Dural tear was seen in the compound type depressed fracture than simple type in this study, which is consistent with the study by Steinbok et al 19 In this study, we have observed infection rate of 2%.…”

Section: Discussioncontrasting

confidence: 62%

“…9,16,17 This study revealed early epilepsy in 4 % versus late epilepsy in 2% of the patients. Al-Haddad et al 17 reported early epilepsy of 12.3% versus late epilepsy of 6.9%, Jennett et al 10 found early epilepsy of 10 % versus late epilepsy of 15% and Mukherjee et al 16 has mentioned late epilepsy of 3.7% versus 0% in simple suturing and elevation debridement group respectively. Focal deficit was observed in 8 % patients in this study.…”

Section: Discussionmentioning

confidence: 82%

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Study of outcome of patients sustaining depressed skull fracture following blunt head trauma

Kc¹,

Shakya²,

Thapa³

2018

J Coll Med Sci-Nepal

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Background: One of the common neurosurgical conditions is depressed skull fracture. It could be simple or compound type. This study aims to assess the outcome of the patients with depressed skull fracture.Material and Methods: Retrospective cohort study of the patients admitted with depressed skull fracture after sustaining blunt head trauma was done. Data were collected with regard to age, sex, mode of injury, time delay, Glasgow coma scale (GCS), epilepsy, focal neurological deficit, CT scan findings, treatment given, infection and Glasgow outcome scale (GOS). Results: Total of 50 patients were included, of which 68% were male and 32% were female with mean age of 21.02 ± 18.78 years. Fall was the commonest mode of injury constituting 60% of patients, 80% of the patients presented within 12 hours of injury and 86% of them sustained mild head injury. Fracture was of compound type in 56% and simple type in 44%. Wound debridement and suturing was performed in 26% and Craniotomy and elevation was done in 42%. Dural tear was observed in 47% who were operated. Early epilepsy was seen in 4% and late epilepsy in 2% and infection rate of 2%. Outcome was Favorable in 98% patients. Significant correlation noted between admission GCS with GOS (p=0.006) whereas no correlation was seen between time of presentation with infection (p=0.09).Conclusion: Mild head injury was the commonest form of presentation. Most of the patients have unfavorable outcome and with low risk of infection and epilepsy. Good admission GCS correlated with favorable outcome.Keywords: blunt head trauma; depressed skull fracture; epilepsy; infection; outcome.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 82%

Study of outcome of patients sustaining depressed skull fracture following blunt head trauma

Kc¹,

Shakya²,

Thapa³

2018

J Coll Med Sci-Nepal

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“…17,37 However, the burden experienced by the caregivers of TBI or other neurological illnesses may be higher in developing countries like India due to the poor support system, inadequate use of hospital services, home care strategies, and rehabilitation facilities. 38,39 Our study also has found an adverse impact of the cognitive-behavioral and functional impairment of the TBI survivors on caregiver burden. Managing patients with behavioral symptoms such as anxiety, depression, and irritability is a stress-inducing task for the caregivers.…”

Section: Discussionmentioning

confidence: 55%

Cognitive, Behavioral, and Functional Impairments among Traumatic Brain Injury Survivors: Impact on Caregiver Burden

Devi

Khan

Rana

et al. 2020

JNRP

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Background The burden of cognitive, behavioral, and functional impairments after traumatic brain injury (TBI) is still not highlighted much, but its impact on caregivers is socio-economically relevant. The objectives of the study were to assess cognitive, behavioral, and functional impairments in patients of TBI and its impact on caregiver burden. Materials and Methods A descriptive cross-sectional study was conducted using a total enumeration sampling technique. Mini-mental status examination, neuropsychiatric inventory and Rappaport’s disability rating scale were used to assess patients’ cognitive, behavioral, and functional impairments, respectively. Zarit Caregiver Burden Scale was executed to quantify the caregiver burden. Results Fifty patients of TBI and their caregivers were enrolled. Among these, 24% had moderate cognitive impairments. Among behavioral symptoms, 40% had agitation, 24% had depression, 18% had anxiety, and 16% had irritability. Moderate functional disability was reported by 18% of the patients, while 2% reported severe functional disability. Moderate to severe caregiver burden was reported by 8% of caregivers. Patients’ behavioral (r = 0.507, p < 0.001), functional (r = 0.473, p = 0.001), and cognitive (r = –0.438, p = 0.001) impairments had significant correlations with caregiver burden. Conclusion Patients develop cognitive, behavioral, and functional disability after TBI. The caregiver burden increases significantly with cognitive dysfunction, behavioral symptoms, and impaired functional status of patients. Therefore, appropriate support is to be provided to caregivers as well as patients.

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“…Similar male preponderance is noted in other studies too. 8,11 RTA was most common cause of depressed fracture (50%). However, some other studies implicate fall as the most common mode of injury.…”

Section: Discussionmentioning

confidence: 99%

Depressed Skull Fractures- Case Series of 100 Patients

Shukla¹,

Jain²

2018

jebmh

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BACKGROUND Depressed fracture is common following head injury and its management is controversial. These are often associated with considerable morbidity and mortality. This study aims to evaluate various aspects including outcome of depressed skull fractures. MATERIALS AND METHODS 100 patients of depressed skull fractures were admitted in MLB Medical College, Jhansi over a period of three years from June 2014 to June 2017. These patients were evaluated with respect to age, sex, mode of injury, sites of injury, Glasgow coma score (GCS) at the time of admission, early and late epilepsy, focal neurological deficit, CT scan findings, infection and treatment. RESULTS There were 68 males and 32 females. 15-30 years (32%) was the most commonly affected group. RTA (50%) was the most common cause followed by fall (25%) and physical assault (25%). Most common site of fracture was in parietal region (55%). GCS was 13-15 in 80% patients. Fracture was compound type in 82% and simple in 18%. Favourable outcome was achieved in 98% patients especially in those with better presenting GCS. CONCLUSION Most patients with early and proper treatment of depressed fractures have favourable outcome. Good GCS score at admission correlated with better outcome.

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Prospective comparison of simple suturing and elevation debridement in compound depressed fractures with no significant mass effect

Abstract: Simple suturing seems to be an equally good option in patients with compound depressed fracture with no significant mass effect or brain matter herniation.

Cited by 18 publications

References 15 publications

Study of outcome of patients sustaining depressed skull fracture following blunt head trauma

Study of outcome of patients sustaining depressed skull fracture following blunt head trauma

Cognitive, Behavioral, and Functional Impairments among Traumatic Brain Injury Survivors: Impact on Caregiver Burden

Depressed Skull Fractures- Case Series of 100 Patients

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