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目的：通过对小儿颅骨骨折重要的远期并发症—生长性骨折的研究，为临床上避免颅脑损伤后出现远期并发症提供参考。方法：９例儿童生长性骨折患儿有明确头部外伤史。应用Ｘ线平片，头颅ＣＴ扫描，磁共振成像（ＭＲＩ）和其中３例颅骨修补术进行观察。同时应用经颅多普勒超声技术（ＴＣＤ）对９例患儿的颅内血流速度进行了检测。结果：头颅正侧位平片、ＣＴ和ＭＲＩ可见大小不等的颅骨缺损区，单侧或双侧脑萎缩，脑囊肿形成和脑穿通畸形出现。３例患者实施手术治疗，术中可见帽状腱膜下组织增厚、骨缺损边缘骨板全层增厚。ＴＣＤ可见５例患儿颅内血流速度减低为１０～３５ｃｍ／ｓ；２例患儿血流速度正常；２例血流速度略高。结论：儿童颅骨生长性骨折作为颅骨骨折重要的远期并发症其诊断意义非常重要。颅骨骨折和硬脑膜破裂是生长性骨折的决定性因素。ＴＣＤ对检测颅内血流动力学有重要的参考意义。
OBJECTIVE: To provide a reference for clinical prevention of long-term complications after traumatic brain injury by studying the long-term complication of fractures of the child’s skull, which is an important long-term complication. Methods: Nine children with growth fractures have a clear history of head injury. X-ray plain film, cranial CT scan, magnetic resonance imaging (MRI) and 3 cases of skull repair were observed. At the same time, the transcranial Doppler ultrasound (TCD) in 9 cases of children with intracranial blood flow velocity were detected. Results: The skull posterior lateral plain radiographs showed skull defects with different sizes on both CT and MRI. Atrophy or bilateral brain atrophy, cerebral cyst formation and penetrating cranial deformity appeared. Surgical treatment was performed in 3 patients. The thick apical subgaleal tissue was seen in the operation, and the full thickness of the marginal plate of the bone defect was thickened. TCD showed 5 cases of children with intracranial blood flow decreased to 10 ~ 35cm / s; 2 cases of children with normal blood flow velocity; 2 cases of blood flow velocity slightly higher. Conclusion: It is very important to diagnose cranial growth fracture in children as an important long-term complication of skull fracture. Skull fracture and dura rupture are the determinants of a growth fracture. TCD for the detection of intracranial hemodynamics have important reference value.