A novel classification of frontal bone fractures: The prognostic significance of vertical fracture trajectory and skull base extension

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Ravi K GargLindell R Gentry

Abstract

The broad spectrum of frontal bone fractures, including those with orbital and skull base extension, is poorly understood. We propose a novel classification scheme for frontal bone fractures. Maxillofacial CT scans of trauma patients were reviewed over a five year period, and frontal bone fractures were classified: Type 1: Frontal sinus fracture without vertical extension. Type 2: Vertical fracture through the orbit without frontal sinus involvement. Type 3: Vertical fracture through the frontal sinus without orbit involvement. Type 4: Vertical fracture through the frontal sinus and ipsilateral orbit. Type 5: Vertical fracture through the frontal sinus and contralateral or bilateral orbits. We also identified the depth of skull base extension, and performed a chart review to identify associated complications. 149 frontal bone fractures, including 51 non-vertical frontal sinus (Type 1, 34.2%) and 98 vertical (Types 2-5, 65.8%) fractures were identified. Vertical fractures penetrated the middle or posterior cranial fossa significantly more often than non-vertical fractures (62.2 v. 15.7%, p = 0.0001) and had a significantly higher mortality rate (18.4 v. 0%, p < 0.05). Vertical fractures with frontal sinus and orbital extension, ...Continue Reading

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Citations

May 16, 2017·Current Opinion in Otolaryngology & Head and Neck Surgery·Robert J Chouake, Brett A Miles
Jul 15, 2017·AJR. American Journal of Roentgenology·Michael J ReiterJared M Theler
Jan 8, 2020·Annals of Maxillofacial Surgery·Alagappan MeyyappanJessica Yolanda Jeevitha
Aug 31, 2020·International Journal of Oral and Maxillofacial Surgery·N R Johnson, M J Roberts
Dec 29, 2020·Plastic and Reconstructive Surgery·Selim G GebranMichael P Grant

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