From the Research
Treatment for scalp fractures varies significantly depending on the degree of injury, with the most recent and highest quality study 1 suggesting a simplified approach for management of scalp wounds with exposed skull. For mild fractures, conservative management is recommended, including rest, pain control with acetaminophen (500-1000mg every 6 hours) or NSAIDs like ibuprofen (400-600mg every 6-8 hours), and protection from further trauma. Some key points to consider in the treatment of scalp fractures include:
- The degree of injury: mild, moderate, or severe
- The location of the fracture: scalp, skull, or facial bones
- The patient's overall health status: age, medical history, and current medications
- The need for surgical intervention: open reduction and internal fixation (ORIF) or reconstructive surgery
- The importance of post-surgical care: antibiotics, pain management, and physical therapy
- The role of rehabilitation: restoring function and strength, and minimizing complications
According to the study 1, removal of the outer cortex of exposed skull bone has proven effective in the management of complex scalp wounds, and this approach can be used in conjunction with conservative wound therapy to promote healing. Additionally, the study 2 suggests that the reconstructive surgeon should strive to use the simplest reconstructive technique while optimizing aesthetic outcomes, and that the reconstruction method should be tailored to the patient's health status, desires, and aesthetic considerations. It is also important to note that antibiotic prophylaxis may be necessary in some cases, as suggested by the study 3, which recommends against the use of prophylactic antibiotics for all adult patients with mandibular or non-mandibular facial fractures undergoing non-operative or operative procedures, but suggests that a narrow-spectrum antibiotic such as cefazolin may be used in certain situations.
Overall, the treatment approach for scalp fractures should be individualized and based on the specific needs and circumstances of each patient, with the goal of restoring function and minimizing complications. Some possible treatment options for scalp fractures include:
- Conservative management: rest, pain control, and protection from further trauma
- Surgical intervention: ORIF or reconstructive surgery
- Post-surgical care: antibiotics, pain management, and physical therapy
- Rehabilitation: restoring function and strength, and minimizing complications
- Reconstructive surgery: using vascularized tissue or local flap reconstruction to promote healing and optimize aesthetic outcomes.