Compound elevated skull fracture: a forgotten type of skull fracture.
OBJECTIVE
We report 4 patients who presented with a rare type of vault fracture. This form of fracture has only been described in few instances in the literature.


METHODS
All the patients presented with elevation of free skull fracture fragments. The etiologies were assault (1 patient), domestic accident (1 patient), and road traffic accident (2 patients). All the fractures were compound as in previously reported cases. Delay in surgery resulted in cerebral abscess in 1 patient. Surgery was performed in all the patients: wound debrident, duroplasty, and reduction of fracture in 3 patients and craniotomy with excision of abscess in 1 patient. Two of the patients did well after surgery. The patients with abscess died 9 days after surgery. Another patient developed CSF fistula after surgery, and died of aspiration while waiting for the closure of the fistula.


CONCLUSIONS
Elevated skull fractures in our series were all compound fractures. Both long, sharp objects as well as blunt objects can cause this injury. Delay in surgery could result in intracranial sepsis. We suggest that this fracture should be included in the classification of skull fractures.
Adeolu
Augustine Abiodun
AA
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria 20001. adeoluaa@yahoo.com
Shokunbi
Matthew Temitayo
MT
Malomo
Adefolarin Obanisola
AO
Komolafe
Edward Oluwole
EO
Olateju
Samuel Oluremi
SO
Amusa
Yemisi Bola
YB
D000328:Adult; D002648:Child; D005260:Female; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed