00:00
Now when it comes to fractures,
you can have compound or displaced.
00:04
These are just terms that you'll hear
when you're caring for patients.
00:08
So I want you to understand
the vocabulary
that we use to talk
about traumatic brain injuries.
00:13
So, compound is occurring
with an open wound.
00:17
Just like if we talked
about a compound leg fracture,
we're talking about
a compound skull fracture,
it's occurring with an open wound.
00:23
Displaced is a closed wound,
but the end of the fractures
no longer meet.
00:29
So, think about that being in your skull,
it's not open,
but the skull doesn't....
00:34
The skulls experienced a fracture
and the ends don't meet anymore.
00:38
So, instead of this, I have this.
00:41
Okay, so that's going to give
us potentially some problems
depending on how bad
or difficult that injury was.
00:47
Okay, so the linear in skull fractures
are the most common type
and they're also usually
the least problematic.
00:56
Look at the graphic drawing there.
00:58
We've shown you
what a skull fracture would look like
and you also see
in the close-up picture
how that just a little tiny crack.
01:04
They shouldn't be that big a problem.
01:06
It's the most common type that we see.
01:08
It's a break in the bone,
but it doesn't move the bone.
01:12
And usually we don't do much for it
beyond just keeping an eye on the patient,
seeing if they have
any additional problems.
01:18
Now you wouldn't wish this on anyone
because something traumatic
happened to their head,
but it shouldn't be that big
of a problem.
01:27
This one...
01:28
Ouch. Look at that.
01:31
You see where the arrow is pointing?
They've got a divot
in their skull, right?
It makes me think when you golf
and you get a big chunk of grass up.
01:37
So they've got like
if I taken my thumbprint and...
01:40
Really pressed in on that.
01:42
So look at the close-up in the graphic.
Can you see what you have there?
There's the outside of the head.
01:47
Then you see how that skull is dented in.
01:50
Oh, there's some red stuff
underneath there.
01:52
Yeah, likely it have some blood there
right around the brain tissue.
01:58
So, in a depressed skull fracture,
the bone is pressed into the dura.
02:03
Remember the dura
are the really tough layer
that covers the outside of the brain.
02:08
Now often these patients
have to go to surgery,
you have to kind of maybe
try to elevate that bone.
02:13
Think of it like a dent in a car,
we have to kind of get that out.
02:16
Well, the same thing for your skull.
02:18
So, it might have to go
to surgery to elevate the bone.
02:20
You might need
to debride the wound
and you might need
to repair the dura.
02:25
So, the linear fracture,
not a big deal.
02:28
Depressed skull fracture,
now we're getting more serious.
02:32
And depending on how big it is
and where it is,
the patient may need surgery
for follow up.
02:37
Now, this one is a tongue-twister.
02:39
Diastatic skull fractures.
02:42
This is more common
in older newborns and in infants.
02:46
Okay, so this is what
you're going to see in little guys.
02:49
So, older newborns and infants
often can have this kind of fracture
because it happens
along the skull suture lines
and it widens them.
02:57
So, this is one that, hopefully,
you don't see very often.
03:00
But if you do, know that
it's going to be a fracture
right along the suture line
that causes that suture line to widen.
03:07
Now, remember, they don't have
stitches in their skull.
03:10
That's just what we call the spaces
where the skull is able to expand
as they're growing.
03:15
That's what a suture line is.
03:17
Now, this is the one
that's the biggest deal, okay?
Basilar skull fracture.
03:25
So we're gonna hang out here
for a little bit
because it's really important
that you recognize what this looks like
and you look for the key signs
that could happen.
03:33
So this is the most serious
type of skull fracture
is a basilar skull fracture.
03:38
It involves a break in the bone
at the base of the skull.
03:42
Now take a look at that drawing.
03:45
See where you have
the little arrow pointing in,
you can see that fracture
way down deep in there.
03:51
That's a break
or a fracture in the bone
at the base of the skull.
03:56
This can lead to a really big problem.
03:59
And I'll help you understand why.