DELAYED COMPLICATIONS OF ETHMOID FRACTURES - A GROWING FRACTURE PHENOMENON

Delayed complications of ethmoid fractures are considered relatively r are. However, meningitis, recurrence of previously ceased cerebrospina l fluid rhinorrhea and delayed onset of cerebrospinal fluid rhinorrhea are possible even years after trauma. We report 10 consecutive patien ts with delayed complications of ethmoid fractures, whom we treated ov er the past 11 years. All patients had previously sustained a closed h ead injury and had remained anosmic. Variously after trauma (ranging f rom 2 months to 31 years), these patients were re-admitted because of meningitis (6 cases), recurrence of previously ceased cerebrospinal fl uid rhinorrhea (3 cases), and delayed onset of cerebrospinal fluid rhi norrhea (1 case). In all cases the delayed complications were associat ed with relatively large defects of the ethmoid bone. These bone lesio ns were now evident even in those patients whose radiological assessme nts had been normal after trauma. All patients underwent a successful surgical repair and remained well during the follow-up. We discuss the possibility that delayed complications of ethmoid fractures are due t o a mechanism like that of ''growing fractures'' in children.