[Clinical examination in open fractures of the frontal bone]

Fractures of the frontal bone most often occur with injuries: in traffic accidents, at work, at home, falls on stairs or slippery surfaces, in sport accidents, hoof injuries, etc. They are mostly seen within combined injuries, much less often as isolated.

There were no patients under the age of 20; two were in their thirties, three each in their forties and fifties, and one patient in his sixties. Sex distribution: seven males and two females. Seven patients were injured in traffic accidents, and two working at home.

Four of nine X-rays, although technically valid, did not reveal fracture lines on the frontal bones. In these cases the fracture was diagnosed by surgical exploration during the treatment of the soft tissue injuries of the frontal region. We must therefore point to the importance of surgical exploration of each, even the slightest injury of the soft tissues of the frontal region, so that the fractures of the frontal bone are not overlooked. Standard X-rays must be interpreted as a supplementary diagnostic procedure, but cannot be considered as absolutely reliable, since the lines can be obscured due to the thickness of the bone structures. The revision was made via the fronto-orbital passage. The mucosae of the posterior wall was intact in five cases, while four cases had a fracture of the interior wall as well, without dislocation of fragments. We preserved the sinus cavities of five patients with only frontal wall injuries, while obliteration was performed in four cases due to the fracture of the interior wall.

We have ascertained that standard radiography is an unreliable diagnostic procedure and, especially in case of minor injuries of the frontal bone, surgical exploration of the injured region is an imperative, as the only reliable method of excluding fracture of the frontal bone, and this long-established principle cannot be abandoned in these cases either.