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Advanced Neurology Outcomes of implant usage for depressed skull fractures

4. Discussion
Total 5 7 Surgical reconstruction of DSFs has been achieved using

various implant materials; however, comparative analysis
Adequacy of follow up of cohorts n/a 0 of post-operative outcomes associated with the type of
implant material has yet to be conducted
. With the
[31-33]
goal of improving outcomes in patients presenting to the
emergency department with DSFs, the authors conducted
Was follow‑up long enough for outcomes to occur 1 1 a systematic review to explore the outcomes and operative
considerations associated with DSF reconstruction
achieved through use of either autologous or non-
Outcome autologous implant material (Tables 1 and 2).

Comparative analysis of pre-operative factors, such
Assessment of outcome 1 1 as GCS, was conducted between patients in whom DSF
reconstruction was achieved using either autologous
or non-autologous implant material to identify the
implications of pre-operative GCS assessment on surgical
Comparability Comparability of cohorts on the basis of the design or analysis n/a 1 approach (Table 3). Despite the lack of a statistically
significant difference in pre-operative GCS between the
two groups, there was an advantageous trend toward the
use of an autologous implant among patients with a lower
pre-operative GCS (GCS: 12.8 vs. 14.8) (Table 3). Although
there is limited evidence in the literature citing a preference
Case series/report Demonstration that outcome of interest was not present at start of study 1 1 towards the use of either an autologous or allogenic graft in
patients with lower GCS, it is hypothesized that autologous
grafts are preferred in patients with lower GCS scores to
prevent further complications related to graft rejection .
[34]
It is also possible that patients with the lower GCS scores
Ascertainment of exposure 1 1 were deemed to require more urgent intervention that did
not allow ample opportunity for sourcing an appropriate
however,
graft;
allogenic
further
HLA-matched
investigation is needed to ascertain whether autologous
grafts may enable reduced post-operative complication in
[34]
the association between the time to encounter – defined
Selection of the non‑exposed cohort patients with lower GCS scores . Further evaluation of
as the duration between injury and arrival at the ER – and
Selection n/a 1 its implications on the use of either an autologous or non-
autologous implant also did not reveal any statistically
Representativeness of the exposed cohort 1 1 suggests a trend towards the use of an autologous implant
significant differences. However, comparative analysis
for DSF reconstruction in patients with a shorter time to
encounter (1.67 days vs. 2.68 days), which may support
the hypothesis that autologous implants are preferred
in cases of greater interventional urgency (Table 3). In

Table 1. (Continued) Study type Author and year Case report Anehosur et al., 2022 [17] Cohort Retrospective AbdelFatah cohort et al., 2016 [16] n/a: Not available addition, the association between fracture location and
the type of implant material utilized for reconstruction
was evaluated to identify whether differences in selection
of implant material are preferentially attributable to
fracture location (Table 3). The frontal region of the skull
was the most common location of reconstruction within
both cohorts of patients; however, reconstruction of the

https://doi.org/10.36922/an.247
Volume 2 Issue 1 (2023) 6 frontal region of the skull occurred in 68% of patients in