The patient came to the emergency of Shmaisani hospital at the morning of 17-May-2010 after getting direct trauma by a sharp stone to the forehead without loss of consciousness three hours ago.

CT-scan performed elsewhere showing depressed fracture of the external shell of the frontal sinus.

On examination the patient is alert without neurological deficit and preserved olfaction both sides. There is a cut wound double Y shaped at the site of depression

The wound was cleaned meticulously and the depressed fragments were elevated and removed and their edges were studied, so as to bring them back with good alignment. The lamina interna was intact and the damaged mucosa was dissected and coagulated to prevent future formation of mucocele. Using drill to put sutures was used, but their necessity was abandoned because the construct was stable. The crushed edges of the wound were refreshed and plastic closure of the skin was done using Nylon 6 zero.

Smooth postoperative recovery.

The patient  has wound over the depressed fracture site. This area of the forehead is very important cosmetically and widening of the wound is forbidden.

In case that the wound was not sufficient to perform all the task, bifrontal skin flap is the preferable next option, which in this case was not necessary.