Main Article Content
Abstract
RÉSUMÉ
Introduction. Les Fractures embarrures sont en général causé par les traumatismes crânio-encéphaliques(TCE). L’objectif de cette étude est de déterminer le profil épidémiologique et décrire les aspects cliniques, thérapeutiques et évolutifs des fractures embarrures au CHU la Renaissance de N’Djamena. Méthodologie. il s’agissait d’une étude prospective à visée descriptive et analytique portant sur les patients diagnostiqués fractures embarrure du crâne sur une période de 2 ans du 1er Août 2021 au 31 Juillet 2023. Résultats. Durant la période d’étude, 64 patients ont été pris en charge pour une fracture embarrure du crâne sur un total de 365 cas de TCE soit une fréquence de 17,5%. avec une forte prédominance masculine (94%). Les jeunes de 16-25 ans étaient les plus touchés (29,7%). Les élèves et étudiants sont plus touchés soit 80% des cas. La cause principale était les accidents de la voie publique (50%). La notion de perte de connaissance initiale était retrouvée dans 95,3%. Les céphalées et le trouble de conscience étaient retrouvés respectivement dans 79,7% et 37,5%. Le traitement neurochirurgical avait été effectué chez 51 patients soit 79,7% et la craniotomie avec repositionnement du fragment d’os était la technique la plus utilisée chez 49% des cas opérés. Les séquelles étaient dominées par les céphalées soit 10,8% des cas. Conclusion. La fracture embarrure du crâne est fréquente chez l’adulte jeune de sexe masculin. Les étiologies sont dominées par les accidents de la voie publique. La chirurgie décompressive a permis de réduire et d’amoindrir les séquelles.
ABSTRACT
Introduction. Embarrure fractures are generally caused by traumatic brain injuries (TBI). The aim of this study is to determine the epidemiological profile and describe the clinical, therapeutic, and evolutionary aspects of embarrure fractures at CHU La Renaissance de N'Djamena. Methodology: This was a prospective descriptive and analytical study of patients diagnosed with embarrure fractures of the skull over a period of 2 years from August 1, 2021, to July 31, 2023. Results. During the study period, 64 patients were treated for embarrure fractures of the skull out of a total of 365 cases of TBI, resulting in a frequency of 17.5%, with a strong male predominance (94%). The most affected age group was 16-25 years (29.7%). Students accounted for 80% of the cases. The main cause was road traffic accidents (50%). The initial loss of consciousness was found in 95.3% of cases. Headaches and consciousness disorders were found in 79.7% and 37.5% of cases, respectively. Neurosurgical treatment was performed on 51 patients (79.7%), and craniotomy with repositioning of the bone fragment was the most commonly used technique in 49% of the operated cases. Sequelae were dominated by headaches, accounting for 10.8% of cases. Conclusion. Embarrure fractures of the skull are frequent in young adult males. The main etiology is road traffic accidents. Decompressive surgery has helped reduce and mitigate sequelae.
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References
- Kanikomo D, Sogoba Y, Dama M, Coulibaly, Diarra M S, Thiam A B, et al. Etude épidémiologique, clinique et thérapeutique des fracture embarrure du crâne à propos de 72 cas dans le Service de neurochirurgie CHU Gabriel Touré (Bamako) ; Le Mali Méd. 2015. 13 ; Tome 3.
- Kumar S, Nahar S, Sahana D, et al. A prospective comparative evaluation of surgery and conservative treatment for compound depressed skull fractures. World Neurosurg, 164: e1281–e1289. 10.1016/j.wneu. Chhattisgarh, India. 2022.06.019.
- Tsiaremby M G, Rasolonjatovo C E, Bemora J S, Fitahiantsoa S B, Ratovondrainy W, Rabarijaona M,et al. Management of severe and moderate traumatic brain injuriesin Antsiranana, Madagascar. Rev. Anesth.-Réanim. Med. Urg. Toxicol. 2023; 15(1): 25-31.
- Alihonou T, Fatigba O H, Adjadohoun S, Zanda VM, Hans-Moevi A. Aspects évolutifs des fractures embarrures du crane au sud du Bénin. Cahiers du CBRST, Médecine et Santé Publique N° 16 (2), 2ème semestre 2019 ; ISSN : 1840-703X.
- Hode L, S Mewanou, Y B P Deffon, M Agbo-Panzo, AOuangre, S Madougou. Surgical treatment of traumatic brain injuries in Cotonou: difficulties, results and prospects.JournalELSEVIERNeurochirurgie,Vol 64, Issue 6, December 2018, Pages 410-414.
- Doléagbénou AK, Ahanogbé HK, Kpélao E, Béketi KA, Egu K. Aspects épidémiologiques et prise des traumatismes crânio-encéphaliques de l’adulte au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé. Health Sci. Dis Vol 20 (6) Décembre 2019.
- Ki SeongEom. Single-Stage Reconstruction with Titanium Mesh for Compound Comminuted Depressed Skull Fracture. J Korean NeurosurgSoc 63 (5): 631-639, 2020.
- Aziz M M, EL Molla S T, Abdelrahiem H A, Dawood O M. Depressed Skull Fractures Overlying Dural Venous Sinuses: Management Modalities and Review of Literature. Turk Neurosurg. Ain Shams University, Department of Neurosurgery, Cairo, Egypt. 29(6):856-863, 31.05.2019.
- Manne S, Siddartha M, Prakash G, Pratap N, Imran M, Nagarjuna B I, et al. Surgical outcomes in depressed skull fractures: An institutional experience. Asian J Neurosurg. India 2019; 14(03): 815-820.
- shakeel A, Ali A, Lal R, and Farrukh J.Impact of depressed skull fracture surgery on outcome of head injury patients. Articles from Pakistan Journal of Medical Sciences 2018 Jan-Feb; 34(1): 130–134.
- Andrew N, Akshay R, Ramy S, Lauren L, Michael J D, Brandon L. Outcomes of surgical management and implant considerationfor depressed skull fractures: A systematic review. College of Medicine, University of Florida, Gainesville, Florida, USA. AdvNeurol (Singap). 2023 March 31; 2(1).
- Ali L, Badar A. Management of Depressed Skull Fracture. J Saidu Med CollSwat 2021; 11(1):30-33.
- Fahri E, Babar B. Surgical Treatment and Results of Depressed Skull Fracture.Annals of International Medical and Dental Research, Turkey. October 2020 ; Vol (6), Issue (6)
- Anand P, Viraat H, Utkarsh G, Jayendra K, Anil K. Depressed Fractures of Skull: An Institutional Series of 453 Patients and Brief Review of Literature. Asian Journal of Neurosurgery | Volume 13 | Issue 2 |. India 2022-09-20.
- Ritesh S S,SrikantB,Jayashree SP,Rajesh C M. Analysis of Factors Influencing Outcome of Depressed Fracture of Skull. Asian Journal of Neurosurgery; College and BYL Nair Hospital,Mumbai, Maharashtra, India. 2022-09-14.
- Jonathan R G, Jacques L R, Willie E, Andrewn J T Single-Stage Titanium Mesh Cranioplasty for the Treatment of Depressed Skull Fractures. Journal ELSEVIER. World Neurosurgery Vol 173, Peoria, Illinois, USA. May 2023, Pages e62-e65.
- Haider A, Mohammad M, Naeem U H, Muhammad A U, Saqib A, Anwar S. Surgical management and Outcomes of depressed Skull Fractures. Neurosurgery department of Mardan Medical Complex / Bacha Khan Medical College. Pakistan. Vol 15, No.7, JUL 2021.
- SanjeevK, ShashankN, DebabrataS, Amit K J, LavleshR, NamanC et al. A Prospective Comparative Evaluation of Surgery and Conservative Treatment for Compound Depressed Skull Fractures. Journal ELSEVIER. World Neurosurgery ; Vol 164, Chhattisgarh, India. August 2022, Pages e1281-e1289.
- Zabsonre D S. Embarrure du crâne : notre attitude thérapeutique et évolution au service de Neurochirurgie CHU Yalgado Ouédraogo. Journal De Neurologie, Neurochirurgie Et Psychiatrie Guinée, 2(21), 21–29. Ouagadougou Burkina Faso. Vol.2 No 21 (2021).
- Nnadi M O N, Bankole O B and Arigbabu S O. Outcome of surgically treated non-missile traumatic depressed skull fracture. The Nigerian Postgraduate Medical Journal. 2014 Dec; 21(4):311-4.
References
Kanikomo D, Sogoba Y, Dama M, Coulibaly, Diarra M S, Thiam A B, et al. Etude épidémiologique, clinique et thérapeutique des fracture embarrure du crâne à propos de 72 cas dans le Service de neurochirurgie CHU Gabriel Touré (Bamako) ; Le Mali Méd. 2015. 13 ; Tome 3.
Kumar S, Nahar S, Sahana D, et al. A prospective comparative evaluation of surgery and conservative treatment for compound depressed skull fractures. World Neurosurg, 164: e1281–e1289. 10.1016/j.wneu. Chhattisgarh, India. 2022.06.019.
Tsiaremby M G, Rasolonjatovo C E, Bemora J S, Fitahiantsoa S B, Ratovondrainy W, Rabarijaona M,et al. Management of severe and moderate traumatic brain injuriesin Antsiranana, Madagascar. Rev. Anesth.-Réanim. Med. Urg. Toxicol. 2023; 15(1): 25-31.
Alihonou T, Fatigba O H, Adjadohoun S, Zanda VM, Hans-Moevi A. Aspects évolutifs des fractures embarrures du crane au sud du Bénin. Cahiers du CBRST, Médecine et Santé Publique N° 16 (2), 2ème semestre 2019 ; ISSN : 1840-703X.
Hode L, S Mewanou, Y B P Deffon, M Agbo-Panzo, AOuangre, S Madougou. Surgical treatment of traumatic brain injuries in Cotonou: difficulties, results and prospects.JournalELSEVIERNeurochirurgie,Vol 64, Issue 6, December 2018, Pages 410-414.
Doléagbénou AK, Ahanogbé HK, Kpélao E, Béketi KA, Egu K. Aspects épidémiologiques et prise des traumatismes crânio-encéphaliques de l’adulte au Centre Hospitalier Universitaire Sylvanus Olympio de Lomé. Health Sci. Dis Vol 20 (6) Décembre 2019.
Ki SeongEom. Single-Stage Reconstruction with Titanium Mesh for Compound Comminuted Depressed Skull Fracture. J Korean NeurosurgSoc 63 (5): 631-639, 2020.
Aziz M M, EL Molla S T, Abdelrahiem H A, Dawood O M. Depressed Skull Fractures Overlying Dural Venous Sinuses: Management Modalities and Review of Literature. Turk Neurosurg. Ain Shams University, Department of Neurosurgery, Cairo, Egypt. 29(6):856-863, 31.05.2019.
Manne S, Siddartha M, Prakash G, Pratap N, Imran M, Nagarjuna B I, et al. Surgical outcomes in depressed skull fractures: An institutional experience. Asian J Neurosurg. India 2019; 14(03): 815-820.
shakeel A, Ali A, Lal R, and Farrukh J.Impact of depressed skull fracture surgery on outcome of head injury patients. Articles from Pakistan Journal of Medical Sciences 2018 Jan-Feb; 34(1): 130–134.
Andrew N, Akshay R, Ramy S, Lauren L, Michael J D, Brandon L. Outcomes of surgical management and implant considerationfor depressed skull fractures: A systematic review. College of Medicine, University of Florida, Gainesville, Florida, USA. AdvNeurol (Singap). 2023 March 31; 2(1).
Ali L, Badar A. Management of Depressed Skull Fracture. J Saidu Med CollSwat 2021; 11(1):30-33.
Fahri E, Babar B. Surgical Treatment and Results of Depressed Skull Fracture.Annals of International Medical and Dental Research, Turkey. October 2020 ; Vol (6), Issue (6)
Anand P, Viraat H, Utkarsh G, Jayendra K, Anil K. Depressed Fractures of Skull: An Institutional Series of 453 Patients and Brief Review of Literature. Asian Journal of Neurosurgery | Volume 13 | Issue 2 |. India 2022-09-20.
Ritesh S S,SrikantB,Jayashree SP,Rajesh C M. Analysis of Factors Influencing Outcome of Depressed Fracture of Skull. Asian Journal of Neurosurgery; College and BYL Nair Hospital,Mumbai, Maharashtra, India. 2022-09-14.
Jonathan R G, Jacques L R, Willie E, Andrewn J T Single-Stage Titanium Mesh Cranioplasty for the Treatment of Depressed Skull Fractures. Journal ELSEVIER. World Neurosurgery Vol 173, Peoria, Illinois, USA. May 2023, Pages e62-e65.
Haider A, Mohammad M, Naeem U H, Muhammad A U, Saqib A, Anwar S. Surgical management and Outcomes of depressed Skull Fractures. Neurosurgery department of Mardan Medical Complex / Bacha Khan Medical College. Pakistan. Vol 15, No.7, JUL 2021.
SanjeevK, ShashankN, DebabrataS, Amit K J, LavleshR, NamanC et al. A Prospective Comparative Evaluation of Surgery and Conservative Treatment for Compound Depressed Skull Fractures. Journal ELSEVIER. World Neurosurgery ; Vol 164, Chhattisgarh, India. August 2022, Pages e1281-e1289.
Zabsonre D S. Embarrure du crâne : notre attitude thérapeutique et évolution au service de Neurochirurgie CHU Yalgado Ouédraogo. Journal De Neurologie, Neurochirurgie Et Psychiatrie Guinée, 2(21), 21–29. Ouagadougou Burkina Faso. Vol.2 No 21 (2021).
Nnadi M O N, Bankole O B and Arigbabu S O. Outcome of surgically treated non-missile traumatic depressed skull fracture. The Nigerian Postgraduate Medical Journal. 2014 Dec; 21(4):311-4.