Diagnosis and treatment of growing skull fracture in infants and young children

Abstract:

Objective：To discuss the pathogensis，clinical features and treatment of growing skull fractures（GSF） in infants and young children. Methods：Eleven subjects with growing skull fractures in past five years were investigated retrospectively in Kunming’s Children’s Hospital between 2009 and 2014. The clinical symptoms，pathogensis and imaging characteristics were analyzed． All patients received the surgery. Cranioplasty was carried out while the dura was repaired. Results：The age of the patients ranged from 6 months to 3.6 years. All 11 subjects had the history of head trauma，and the clinical symptoms included skull defect，soft pulsatile mass and neurologic dysfunction. The cysts in the defect area and encephalomalacia were shown clearly by CT scan. The width of fracture ranged from 1.5 cm to 3 cm. Ten patients under－went the duraplasty and cranioplasty surgery with autogenous bone，and 1 patient underwent cranioplasty with Titanium plate fixation. All patients recovered well. All patients received follow-up from 6 to 24 months. Conclusion：GSF only occur in the infants and young children. The most important factors of GSF include skull fracture and dural tear. The duraplasty and cranioplasty surgery is necessary once the GSF is diagnosed. The key procedure is to perform a watertight dura.