Compound frontobasal skull fractures: surgical management of the acute phase

The management of frontobasal skull fractures must be dealt with in a multidisciplinary manner. The advent of computed tomography has simplified the emergency radiologic investigation and expedited immediate surgical intervention. The major problem to be dealt with is closure of the frontobasal dura, which we accomplish by using an autogenous fascial graft packed under the frontal lobes and secured basally with autogenous adipose implants. In such contaminated injuries, the use of a triple antibiotic regimen should be considered based on the chance of eliminating resistant organisms.