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Old 05-20-2014
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Default head trauma

MTB3 P.287

A man was hit over the head with a baseball bat during a mugging. He has a scalp laceration and a linear skull fracture on CT scan. He denies loss of consciousness. There are no neurological signs on exam. Is surgery indicated?

Answer: No surgical intervention is needed for an asymptomatic head injury with a closed skull fracture (no overlying wound) alone. The next step in management is to clean any lacerations.


the scenario describes an open skull fracture from what i see
my question is why no surgical intervention ?
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Linear fractures without hematoma or depression are not surgical
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Quote:
Originally Posted by drivenby View Post
Linear fractures without hematoma or depression are not surgical
yes i agree
but if there is the overlying laceration wouldn't it make it an open skull fracture ?
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linear mean no displacement...no displacement no surgery
...
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I had thought so too but I m thinking because it's a linear fracture and not comminuted and not exposed (scalp bone visible to eyes), they are not taking it as open fracture.
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WTF is the definition of this exam
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May be the overlying wound has to breech 5 layers of scalp to categorize the fracture as open. I don't know
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