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Advanced Neurology Outcomes of implant usage for depressed skull fractures

autologous patient population was predominantly middle- Author contributions
aged females (Table 2). In addition, significant differences
were reported between post-operative GCS and minimum Conceptualization: Brandon Lucke-Wold, Andrew Nguyen
follow-up times between both groups. This was likely Formal analysis: Andrew Nguyen
due to small sample size leading to differences that may Investigation: Andrew Nguyen, Michael Joseph Diaz
not be representative of patients receiving autologous and Methodology: Andrew Nguyen
nonautologous implants. In addition, the country of origin Writing – original draft: Andrew Nguyen, Akshay Reddy,
Ramy Sharaf, Lauren Ladehoff, Michael Joseph Diaz
for included studies should be further analyzed with a Writing – review & editing: Andrew Nguyen, Akshay
report of justification regarding chosen implant material.
Finally, pooled effect sizes described here could not be Reddy, Ramy Sharaf, Lauren Ladehoff, Michael Joseph
rigorously adjusted for covariates. Diaz, Brandon Lucke-Wold

With the goal of improving patient outcomes in Ethics approval and consent to participate
addressing DSF, we hope to address how implant material Not applicable.
may affect post-operative outcomes. Future research
should be conducted, adjusting for standard of care across Consent for publication
national health systems, patient socio-demographic factors,
and patient comorbidities. We also require a clearer focus Not applicable.
on primary outcomes evaluated to better compare across Availability of data
groups.
All data generated or analyzed during this study are
5. Conclusions included in this published article.
The current study represents a scoping systematic review References
of the Web of Science, Scopus, and PubMed databases.
Here, we provide novel efforts to elucidate depressed 1. Abdelmalik PA, Draghic N, Ling GS, 2019, Management of
skull fracture outcomes in patients receiving autologous- moderate and severe traumatic brain injury. Transfusion,
based interventions compared to non-autologous-based 59(S2): 1529–1538.
interventions. We identified trends toward autologous https://doi.org/10.1111/trf.15171
implant usage among low preoperative-GCS patients, 2. Ahmad S, Afzal A, Rehman L, et al., 2018, Impact of
though DSF patients receiving autologous grafts reported depressed skull fracture surgery on outcome of head injury
greater likelihood of postoperative complication. Still, patients. Pak J Med Sci, 34: 130–134.
however, these data largely corroborate previous research https://doi.org/10.12669/pjms.341.13184
indicating little-to-no statistically significant contributions
of selected implant material towards post-operative 3. Ali L, Badar A, 2021, Management of depressed skull
complication rates among neurosurgical patients. fracture. JSMC, 11: 30–33.
Limitations of the present review include uncontrolled https://doi.org/10.52206/jsmc.2021.11.1.30-33
cofounders in patient and hospital factors, distinctly 4. Prakash A, Harsh V, Gupta U, et al., 2018, Depressed
heterogenous patient cohorts, and inconsistent follow-up fractures of skull: An institutional series of 453 patients and
times. Future investigation of implant considerations for brief review of literature. Asian J Neurosurg, 13: 222–226.
depressed skull fractures should focus its efforts on studying
large, non-biased treatment cohorts with adequate control https://doi.org/10.4103/ajns.AJNS_168_16
measures in place for differences attributable to interacting 5. Kumar S, Nahar S, Sahana D, et al., 2022, A prospective
factors. comparative evaluation of surgery and conservative
treatment for compound depressed skull fractures. World
Acknowledgments Neurosurg, 164: e1281–e1289.
None. https://doi.org/10.1016/j.wneu.2022.06.019
6. Márquez-García JC, Granados-Sáncheza AM, Moreno-
Funding Arango I, 2022, Isolated depressed fracture of the inner table
None. of the skull. Interdiscip Neurosurg, 30: 101604.
https://doi.org/10.1016/j.inat.2022.101604
Conflict of interest
7. Marbacher S, Andres RH, Fathi AR, et al., 2008, Primary
The authors declare that they have no conflict of interest. reconstruction of open depressed skull fractures with

Volume 2 Issue 1 (2023) 9 https://doi.org/10.36922/an.247