Clinical Features of the Patients with Fracture on the Frontal Bone

전두골 골절손상 환자의 임상 고찰

  • Kim, Sahng Hyun (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Whang, Kum (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Pyen, Jin Soo (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Hu, Chul (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Hong, Soon Ki Hong (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Kim, Hun Joo (Department of Neurosurgery, Wonju College of Medicine, Yonsei University)
  • 김상현 (연세대학교 원주의과대학 신경외과학교실) ;
  • 황금 (연세대학교 원주의과대학 신경외과학교실) ;
  • 변진수 (연세대학교 원주의과대학 신경외과학교실) ;
  • 허철 (연세대학교 원주의과대학 신경외과학교실) ;
  • 홍순기 (연세대학교 원주의과대학 신경외과학교실) ;
  • 김헌주 (연세대학교 원주의과대학 신경외과학교실)
  • Received : 1999.07.06
  • Accepted : 1999.12.03
  • Published : 2000.03.28

Abstract

Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.

Keywords