Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
02-APRIL-2008 ABDEL-AZIZ HUSSEIN KHALEEL 32
YEARS COMPOUND DEPRESSED FRACTURE OF THE RIGHT PARIETAL BONE.
The patient came to the
emergency of Shmaisani hospital 01-April-2009
transferred from Aqaba with clinical history of
massive blunt injury to the head during work
with subsequent LOC for more than 2 hours 3 days
CT-scan of the brain and
skull X-ray showed depressed fracture of the
right parietal bone.
On examination the patient is
still drowsy with crushed cut wound in the right
parietal region with dirty ugly wound.
The patient was moving all
limbs without neurologic deficit and he
complained of neck and chest pain.
Considering that the wound is
dirty and the bone fragments were depressed it
was decided to explore the wound and explore the
dura. The fragmented bones were removed in that
fashion so as to use them later. There was hair
and dirt even reaching the intact dura. After
cleaning of the dura of all compressed bony
elements and washing it out of dirt, some of
acceptable bony fragments were used to fill the
bony defect aided with nylon stitches.
Debridement of the wound and routine closure.
In infants with pig-pong
depressed fracture can be managed with tiny
wound with subsequent elevation of the bone.
In adults with compound dirty
wound removal of all bones is a must with
inspection of the dura. Meticulous cleaning of
all the elements and removal of the severely
crushed tissues decrease the possible
postoperative osteomyelitis and possible hidden
complications. The internal layers of the bone
were separated from the outer part and they were
causing the major depression.
So as to avoid using
substitutes for the bone, the bone fragments
must be removed with care, cleaned studied and
if they are acceptable, to use them to fill the
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .