Emergency craniotomy around a compound depressed skull fracture. Retractors were applied to move the scalp and expose the fracture prior surgical repair. A depressed skull fracture results from a blunt force trauma and involves a break of the cranial bone, a "crushed" or inwardly folded portion of skull (i.e. depressed) toward the brain.Most are accompanied by concussion due to the high energy impact or other injuries to the brain due to a subdural or epidural hematoma that can compress the underlying brain tissue. These type of fractures are associated with higher rates of infection, seizure, neurological deficits, and death. Surgical intervention is indicated to stop any form of bleeding and repair the fracture (cranioplasty). Bony fragments are elevated, and the dura is inspected for any tears. Larger pieces may be wired together and titanium mesh also may be used to cover the defect, as well as bone plates and screws.