矢状窦上开放性凹陷性骨折的临床治疗方法探讨

Treatment of open depressed skull fracture overlying superior sagittal sinus

目的探讨矢状窦上开放性凹陷性骨折的治疗方法。方法收集2006年3月～2011年3月住院的矢状窦上开放性凹陷性骨折12例患者资料,对其临床表现、治疗经过和结局进行回顾性分析。结果本组12例患者中1例观察2个月后摘除骨折片,钛网修补;1例清创摘除骨折片,钛网一期修补;10例摘除骨折片,颅骨缺损后期修补。随访1年,按格拉斯哥后果评定,12例均恢复良好。结论对矢状窦上开放性凹陷性骨折的治疗,应根据损伤污染的程度、临床症状、美观需求等因素综合判断选择治疗方案,按具体情况进行单纯的清创缝合、骨折片摘除或一期修复。

Objective To discuss the treatment of open depressed skull fracture overlying superior sagittal sinus. Methods The patients with open depressed skull fracture overlying superior sagittal sinus were included. The patients＇ clinical manifestation, surgical treatment methods, and outcomes were retrospectively analyzed. Results There were 12 patients in the study. One patient underwent simple debridement, and 2 months later were removed bone fragment with titanium mesh replacement. One patient underwent debridement and performed primary reconstruction of skull with tita- nium mesh. Ten patients were removed bone fragment and performed a second cranioplasty. At 12-month follow-up based on Glasgow Outcome Scale, 12 patients were good recovery. Conclusion The treatment of open depressed skull fracture overlying superior sagittal sinus should be based on the degree of wound contamination, clinical manifestation and gross cosmetic deformity. The treatment choice may be debridement, bone fragment removal or primary reconstruction of skull with titanium mesh.