Healing following cranial trauma.

This paper reports on the gross appearance of the initial osseous response following cranial gunshot wounds. A total of 127 adult crania and cranial sections were analyzed for four types of bone response: osteoblastic, osteoclastic, line of demarcation, and sequestration. In general, no osteoblastic or osteoclastic response was noted during the first week. This response was followed by an increasing prevalence of expression after this time. By the sixth week postfracture both osteoclastic and osteoblastic activity was scored for 100% of the sample. Further, our observations suggest that the line of demarcation may establish the boundary between the living bone and bone not surviving the fracture. Sequestration appears to be a long-term event and was scored as present well past the eighth week of healing. The osseous expression of infection following fracture was also considered.