No known medical illness
Alleged MVA around 2am early morning
Claimed was MB vs MB (MB loss control & hit the fence, pt was not wearing helmet)
No LOC, noted bleeding from laceration wound over the scalp
No ENT bleed/ othorrhoea/ rhinorrhoea
No vomiting
No seizure
No limb weakness
No SOB/ chest pain/ abdominal pain
o/e:
Alert, conscious
GCS 15/15
Pupils 3/3 ++
Noted laceration wound (T+S done in HTAR) - about 5cm
Another laceration wound Rt temporal region (T+S done in HTAR) - 4cm
Chest/ pelvic spring done : -ve
No neck tenderness
Noted left UL- on immobilizer
BP 116/68
HR 76
Afebrile
Lungs: clear
CVS: DRNM
P/a: soft, nontender
Power Rt UL/ bilateral LL: 5/5
Sensation intact
CT brain:
CT brain:
Rt frontal depresses skull fracture -involving double table extending to superior orbital wall
No obvious ICB/ EDH/ SDH/ SAH seen
BC intact
Emergency elevation of depressed skull fracture
Frontal bone osteotomy done by neuro team with depressed fracture fragment (Lateral portion of the supraorbital rim) attached on the Rt
Depressed fragment elevated and held in place with 4 hole plate and 3 X 5mm screws
Frotal bone segment replaced and secured with horizontal long 16 hole plate across the R supraorbital rim with 5 X 5mm and 1X 4mm screws
All plates and screws from 1.5mm Walter lawrence system - straight reg.
Handed over to neuro team for closure
Post op CT scan:
