{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:46:11Z","timestamp":1789677971730,"version":"4.0.1"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Head trauma is a common cause of morbidity and mortality in the pediatric population and often results in a skull fracture. Pediatric skull fractures are distinct from adult fractures. Pediatric fractures have a greater capacity to remodel, but the pediatric brain and craniofacial skeleton are still developing. Although pediatric head trauma has been extensively studied, there is sparse literature regarding skull fractures. The authors' aim was to investigate the characteristics, injuries, complications, and outcomes of the patients in whom surgical intervention was needed for skull fractures.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors performed a retrospective review of patients presenting to the emergency department of a pediatric Level I trauma center between 2000 and 2005 with skull fractures. Patient demographics, mechanism of injury, associated injuries, fracture bone involvement, surgical intervention, complications, and outcomes were analyzed. Groups treated nonoperatively, for skull fracture repair, and for traumatic brain injury were compared.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 897 patients with a skull fracture were analyzed. Most patients (n = 772, 86.1%) were treated nonoperatively (Non-Op group). Fifty-eight patients (6.5%) underwent repair of the fracture (Repair group) and 67 (7.5%) required intervention for treatment of traumatic brain injury (TBI group). The Non-Op group was significantly younger, and the TBI group had a lower initial Glasgow Coma Scale (GCS) score. A fall (51.2%) was the most common mechanism of injury in the Non-Op group, whereas a motor vehicle crash (23.9%) and being hit in the head with an object (48.2%) were most prevalent in the TBI and Repair groups, respectively. Associated injuries were seen in all 3 groups, with brain injury (hematoma) being the most common. Frontal bone fracture was seen most in the Repair and TBI groups, and the parietal bone was the most frequent bone fractured in the Non-Op group. Patients in the TBI group were much more likely to have 2 or 3 skull bones fractured. In the Repair group, 36.2% had a complication (38.0% intervention related and 62.0% trauma related), but no patient had a worsening of their neurological status. In the TBI group, 48.7% of the patients suffered a complication, the vast majority (90.6%) of which were related to the trauma.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The majority of pediatric skull fractures can be managed conservatively. Of those requiring surgical intervention, fewer than half of the surgeries are performed solely for skull fracture repair only. Patients hit in the head with an object or involved in a motor vehicle crash are more likely to need surgical intervention either to repair the skull fracture or for TBI management, respectively. Frontal bone fractures are more likely to necessitate repair, and those patients treated for TBI have a greater incidence of 2 or 3 bones involved in the fracture. Complications occurred but most were related to underlying trauma, not the surgery. No patients who underwent intervention for repair of their skull fracture only had a worsening of their neurological status.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.5.peds13414","type":"journal-article","created":{"date-parts":[[2014,6,6]],"date-time":"2014-06-06T13:59:11Z","timestamp":1402063151000},"page":"205-211","source":"Crossref","is-referenced-by-count":62,"title":["Pediatric skull fractures: the need for surgical intervention, characteristics, complications, and outcomes"],"prefix":"10.3171","volume":"14","author":[{"given":"Christopher M.","family":"Bonfield","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Naran","sequence":"additional","affiliation":[{"name":"Plastic Surgery, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwaseun A.","family":"Adetayo","sequence":"additional","affiliation":[{"name":"Plastic Surgery, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E.","family":"Losee","sequence":"additional","affiliation":[{"name":"Plastic Surgery, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds13414","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1136\/jnnp.35.3.395","article-title":"Depressed skull fracture: data, treatment, and follow-up in 225 consecutive cases","volume":"35","author":"Braakman","year":"1972"},{"key":"b2-peds13414","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1007\/s00247-010-1555-4","article-title":"Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma","volume":"40","author":"Erlichman","year":"2010"},{"key":"b3-peds13414","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1007\/BF00301021","article-title":"Pediatric depressed skull fractures: analysis of 530 cases","volume":"12","author":"Er\u015fahin","year":"1996"},{"key":"b4-peds13414","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1067\/moe.2000.107974","article-title":"Maxillofacial injuries in the pediatric patient","volume":"90","author":"Haug","year":"2000"},{"issue":"1 Suppl","key":"b5-peds13414","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/BF00272499","article-title":"Rational management of simple depressed skull fractures in infants","volume":"103","author":"Hung","year":"2005"},{"key":"b6-peds13414","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"208","DOI":"10.3171\/jns.1974.41.2.0208","article-title":"Epilepsy after monmissile depressed skull fracture","volume":"41","author":"Jennett","year":"1974"},{"key":"b7-peds13414","series-title":"Childs Nerv Syst","first-page":"258","article-title":"Skull fractures in children: their assessment in relation to developmental skull changes and acute intracranial hematomas","volume":"2","author":"Mann","year":"1986"},{"key":"b8-peds13414","series-title":"Traumatic Brain Injury in the United States: Assessing Outcomes in Children","author":"National Center for Injury Prevention and Control","year":"2000"},{"key":"b9-peds13414","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1227\/00006123-198409000-00005","article-title":"Incidence of skull fractures in Olmsted County, Minnesota","volume":"15","author":"Nelson","year":"1984"},{"key":"b10-peds13414","series-title":"Ulus Travma Acil Cerrahi Derg","doi-asserted-by":"publisher","first-page":"149","DOI":"10.5505\/tjtes.2011.26043","article-title":"Pattern of skull fracture in Iran: report of the Iran National Trauma Project","volume":"17","author":"Saadat","year":"2011"},{"key":"b11-peds13414","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3171\/2009.9.PEDS09180","article-title":"Prevention of growing skull fractures. Report of 2 cases","volume":"5","author":"Sanford","year":"2010"},{"key":"b12-peds13414","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1542\/peds.2005-2588","article-title":"Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States","volume":"118","author":"Schneier","year":"2006"},{"key":"b13-peds13414","series-title":"Pediatr Emerg Care","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1097\/00006565-199706000-00006","article-title":"Skull fractures in infants and predictors of associated intracranial injury","volume":"13","author":"Shane","year":"1997"},{"key":"b14-peds13414","series-title":"Clin Plast Surg","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.cps.2004.03.012","article-title":"Pediatric craniofacial fractures: longterm consequences","volume":"31","author":"Singh","year":"2004"},{"key":"b15-peds13414","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"506","DOI":"10.3171\/jns.1987.66.4.0506","article-title":"Management of simple depressed skull fractures in children","volume":"66","author":"Steinbok","year":"1987"},{"key":"b16-peds13414","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3171\/jns.1989.71.2.0186","article-title":"Management of depressed skull fractures. Selective conservative management of nonmissile injuries","volume":"71","author":"van den Heever","year":"1989"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/14\/2\/article-p205.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/14\/2\/article-p205.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/14\/2\/article-p205.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T16:00:40Z","timestamp":1681574440000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/14\/2\/article-p205.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2014,8]]},"references-count":16,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2014.5.peds13414","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8]]}}}