This is important in children below the age of 4 to avoid the complication of growing skull fracture. As mentioned above, bone fragments should be replaced even in compound fractures and wound debrided. D Fracture skull base . This starts as vault linear fracture and extends into the skull base. It follows the weak points in the skull as the Cribriform plate, foramina and internal ear.
Nerve injury can result involving the olfactory nerves.
Other cranial nerves could be effected as the facial nerve. If the fracture extends into the Cribriform plate and is associated with dural tear CSF leak can result and this is called rhinorrhea. If the fracture extends into the internal ear and the middle ear we can get otorrhea, which is CSF leak from the ear. This is a green stick fracture of the skull , it occurs in the first few months of life when the skull bones are still soft. It is caused after falls when the skull hit the edge of a blunt structure as the edge of a table .It shows as a deformity of the skull , it looks as a shallow trench on the surface of the skull.