Fracture Skull

Subject: Midwifery III (Theory)

Overview

A fissure or depressed fracture of the vault of the skull can occur. Even if the delivery is spontaneous, a projected sacral promontory of the flat pelvis may result in a depressed fracture. The fracture may be linked with a cephalohaematoma, extradural or subdural bleeding, or a hematoma. If the fissure fracture is uncomplicated, it is usually asymptomatic. A depressed fracture may occasionally generate a pressure effect. Neurological manifestations may arise later as a result of the compression effect. In the absence of symptoms, treatment is conservative. In the case of symptoms, the depressed bone must be lifted, or a subdural hematoma may need to be drained or exercised surgically.

The vault of the skull (frontal or anterior section of the parietal bone) fracture might be fissured or depressed.

Causes

The effect of difficult forceps delivery is disproportion or due to incorrect forceps application.
Even if the delivery is spontaneous, a projected sacral promontory of the flat pelvis can result in a depressed fracture.

Clinical features

The fracture could be caused by a cephalohaematoma, extradural or subdural bleeding, or a hematoma. Fissure fractures are frequently asymptomatic if they are simple. Pressure effect may occur from a depressed fracture on rare occasions. Because of the compression impact, neurological manifestations may arise later.

Treatment and management

In the absence of symptoms, treatment is conservative. In the case of symptoms, the depressed bone must be lifted, or a subdural hematoma may need to be drained or exercised surgically.

Things to remember

The vault of the skull (frontal or anterior section of the parietal bone) fracture might be fissured or depressed.
Even if the delivery is spontaneous, a projected sacral promontory of the flat pelvis can result in a depressed fracture.
The fracture could be caused by a cephalohaematoma, extradural or subdural bleeding, or a hematoma.
Fissure fractures are frequently asymptomatic if they are simple.
Pressure effect may occur from a depressed fracture on rare occasions.
Because of the compression impact, neurological manifestations may arise later.
In cases where there are no symptoms, treatment is conservative. In the case of symptoms, the depressed bone must be lifted, or a subdural hematoma may need to be aspirated or surgically exercised.

Questions and Answers

What are the causes and clinical features of fracture skull?

Causes

Effect of a tough forceps delivery that is out of proportion or results from improper forceps application.
Despite the fact that the birth was spontaneous, a depressed fracture could still result from the flat pelvis' projected sacral promontory.

Clinical Features

The fracture may also have a hematoma, extradural bleeding, or subdural hemorrhage. If uncomplicated, fissure fractures typically have no symptoms. Pressure effect could possibly result from a depressed fracture. Later neurological manifestations could happen as a result of the compression effect.