Depressed skull fracture with scalp lacerations communicating with intracranial cavity is best classified as which type of fracture?

• A. Linear skull fracture
• B. Depressed skull fracture
• C. Compound skull fracture
• D. Comminuted skull fracture

Answer: (C)

Open (compound) skull fractures occur when a break in the skull is accompanied by a scalp wound that communicates with the intracranial space. In this scenario, the depressed skull fracture has a scalp laceration that directly opens into the intracranial cavity, so it is an open (compound) fracture. This is the key distinction: the external wound creates a pathway for infection and brain exposure, which is what defines an open/compound fracture. A linear fracture is typically nondisplaced with no skin breach, and a depressed fracture can be open or closed—the important factor here is the skin break and intracranial communication. A comminuted fracture would involve multiple bone fragments, which isn’t specified here.