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December 9, 1939

DEPRESSED SKULL FRACTURES; VALUE OF SURGERY; SEQUELAEAN EIGHT YEAR FOLLOW-UP STUDY OF NINETY-ONE PATIENTS

JAMA. 1939;113(24):2111-2116. doi:10.1001/jama.1939.02800490007002
Abstract

The question of elevation of the depressed fragments in depressed fractures of the skull is one that has been debated for many centuries, and even to this day various opinions are held. It has been assumed that if early elevation is not carried out traumatic cysts, scar formation, adhesions or cerebral softening may occur, which clinically can produce manifestations of psychosis, epilepsy, persistent troublesome and debilitating headache, as well as dizziness.

This series of ninety-one cases has been analyzed for the purpose of determining the disability of the entire group, the sequelae responsible for this disability and the effectiveness of early surgery in the prevention of such symptoms.

This group of ninety-one patients has been divided into five classifications, dependent on the various periods of disability (fig. 1). In group A there are thirty-six patients (39.5 per cent) who were disabled for four months or less. Group B, comprising two

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