MCQ 39 'Fracture-ala-signature' is:

A.Gutter fracture
B.Depressed fracture
C.Ring fracture
D.Sutural separation

The correct answer is B.Depressed fracture

Note: Types of Skull Fracture
a)Depressed Fracture:

• It is caused by a heavy weapon with a small striking surface eg. hammer.
• The fracture bone is depressed inwards and its shape indicates the type of weapon used,thus alsoknown as 'Fracture-ala-signature' or 'Signature fracture'.

Depressed Skull Fracture

b)Fissured Fracture(Linear Fracture):

• It is a linear fracture or crack involving the inner or outer table or both.
• It can not be detected on an x-ray.It can only be detected at biopsy

Fissured Fracture

c)Pond or Indented Fracture:

• These fractures are seen in children because of the elasticity of their bones.
• These occurs due to forcible impact against some protruding project

d)Gutter Fracture

• When a bullet causes a glancing blow,it removes a part of thickness of the skull bone resembling a gutter.
• Usually the inner table is also involved and shows an irregular depressed fracture

e)Comminuted Fracture:

• The bone is broken into two or more pieces

f)Penetrating Fracture:

• It's a clean cut opening due to a penetrating weapon such as a dagger or a bullet.

g)Elevated Fracture:

• It results due to moderately heavy sharp edged weapon eg. axe,which lifts one end of the fractured bone above the surface of skull while the other end is depressed down in the cranial cavity injuring the underlying brain.

h)Ring Fracture:

• This term is commonly used to signify any fracture around the foramen magnum.
• Technically,it means a fissured fracture about 3.5 cm outside the foramen magnum at the back,involving middle ear on sides,and roof of nose anteriorly.
• It's rare fracture and requires a lot of force to produce it.
• It results from fall from height on feet or buttocks.