The shape of the fracture may indicate the type of weapon used. The outer and inner tables of the skull are driven inwards, often causing damage to the brain or its coverings. Depressed – a fracture caused by force applied in a ‘focussed’ area e.g.Mosaic (‘spider’s web’) – a comminuted depressed fracture with radiating fissures.Pond – this is a shallow depressed fracture, more common in infants.Ring – these occur in the posterior fossa around the foramen magnum, particularly following a fall from a height (with primary ‘feet first’ impact), where the kinetic energy transfer is transmitted up the cervical spine.‘Hinge’ fractures occur when the linear fracture passes across the middle cranial fossa, separating the skull base into 2 halves, and may be caused by a heavy blow to the side of the head (e.g. Linear fractures in children or young adults may pass through the suture lines (‘diastatic fracture’). Linear – straight or curved fracture lines, which may radiate from a depressed region, or occur at a distance from the impact site, and tend to occur at ‘unsupported’ regions of the skull (e.g.Skull fractures may be classified by their appearance (Saukko and Knight 2004) Fractures have been absent when an impact force of 1314 N was recorded.ĭepressed left parietal bone fracture ( case 13084 Dr Hani Alsalam)ģD CT reformation of same case as above () A simple fracture can occur by walking into a fixed object (force required = 73N), whilst a simple fall through 1 m causing a frontal impact (510N) can also result in linear or mosaic fractures. During the assessment, the nurse expects to observe Battles sign, which is a sign of basilar skull fracture. Saukko and Knight (Knight's Forensic Pathology, Arnold Publishers 2004) reviewed the force required to cause fractures of the skull, and noted that the average adult head weighs 4.5Kg. Study with Quizlet and memorize flashcards containing terms like The nurse working on the neurological unit is caring for a client with a basilar skull fracture. In addition, the bone fragment may cut the dura mater, a relatively tough covering over the brain, causing a cerebrospinal fluid leak. This type of fracture often causes pressure on the brain or direct injury to the brain. The presence or absence of a skull fracture does not, however, determine survival, as it is the presence or absence of underlying damage to the brain or its coverings that is important. Skull Fracture: Depressed skull fractures involve a portion of the skull extending into the brain cavity. Fractures occur when the elastic limit of the bone has been exceeded, and the formation of a skull fracture depends upon the force applied, the point of impact (thickness of the skull), presence of scalp hair and the direction of impact. The normal thickness of the skull is approximately 4-15 mm (depending upon the site at which it is measured), and the presence of a skull fracture is an indication that severe force has been applied to the skull. Skull radiograph (PA 15 degree angulation Caldwell)
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