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Four Cases of Congenital Depressed Skull Fractures in Neonates

Journal of the Korean Pediatric Society 2000;43(4):567-572.
Published online April 15, 2000.
Four Cases of Congenital Depressed Skull Fractures in Neonates
Byung Soon Kang1, Eun Young Kim1, Chang Weon Oh1, Kyoung Sim Kim1, Yong Wook Kim1, Min Suk Oh2
1Department of Pediatrics, Kwangju Christian Hospital, Kwangju, Korea
2Department of Neurosurgery, Kwangju Christian Hospital, Kwangju, Korea
신생아의 선천성 두개함몰골절 4례
강병순1, 김은영1, 오창원1, 김경심1, 김용욱1, 오민석2
1광주기독병원 소아과
2광주기독병원 신경외과
Abstract
Depressed skull fractures in newborn babies mainly result from birth injury and rarely occurr in intrauterine life without any definable etiology. We present 4 cases of congenital intrauterine depressed skull fractures which were discovered at birth in neonates. Three babies(case 1, 2, 3) had round shallow depressions without adjacent soft tissue injury except the last one(case 4), showing sharp angulation in the center of the depression. They had neither birth trauma nor forceps applications and they were healthy without neurologic symptoms. We performed nonsurgical reduction using vacuum extractor in all cases. Three cases were reduced successfully, but the last one failed due to sharp angulation in the center of the depression. It was reduced successfully by surgical elevation using a Freer elevator. Reduction should be performed in congenital depressed skull fractures without neurologic symptoms, because brain compression by depressed fracture results in brain injury or epileptic focus. Nonsurgical reduction should be prior to surgical reduction because of its technical feasability, safety and good results, but surgical reduction should be attempted in the case of sharp angulation in the center of the depression.
Key Words: Congenital depressed skull fracture, Angulation, Surgical reduction


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