Fracture (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Bone fracture facts
- Introduction and definition of bone fracture
- What causes a bone fracture?
- What are the signs and symptoms of a bone fracture?
- What are common types of bone fractures?
- Broken wrist
- Broken hip
- Broken leg
- Broken shoulder
- Broken hand or fingers
- Open fracture
- Stress fracture
- Compression fracture
- Broken rib
- Skull fracture
- Other fractures
- Bone fracture in children
- How is a bone fracture diagnosed?
- What is the treatment for a bone fracture?
- Bone fracture surgery
- Find a local Doctor in your town
Skull fracture
With the wide availability of CT scans, skull X-rays are rarely taken to diagnose head injury. If a head injury exists, the health care professional will feel or palpate the scalp and skull to determine if there may be a skull fracture present. A nervous system exam may be done assessing brain function. Fractures of the base of the skull may cause hemotympanum (blood behind the ear drum), Battle's sign (bruising behind the ear) ,or raccoon eyes (bruising surrounding the orbits of the eyes).
The skull is a flat, compact bone and it takes significant force to break it. If a skull fracture exists, there is an increased likelihood of bleeding in the brain, especially in children. There are guidelines that are available to decide whether a CT scan is indicated (needed).
Concussion describes a head injury, either a direct blow, or being shaken or jarred where there is a temporary change in mental function, but the victim returns to normal status within 2 hours. With minor head injury, the following risk groups are considered when evaluating need for CT brain scan:
High risk for potential neurosurgical operation
- Abnormal neurologic exam within two hours after injury
- Suspected open or depressed skull fracture
- Any sign of basal skull fracture (blood behind the ear drum, blackened eyes, clear fluid running from the ears, or bruising behind the ear)
- Vomiting - two episodes
- 65 years of age or older
Medium risk (for brain injury on CT)
- Amnesia before impact - more than 30 minutes
- Dangerous mechanism (pedestrian struck by motor vehicle, occupant ejected from motor vehicle, fall from height greater than three feet or five stairs)
Next: Other fractures
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