Ping-pong fractures (PPFs) are rare types of depressed skull fractures that occur in neonates due to mechanical traumatic factors. Such conditions result in inward bowing of the skull bones, but its continuity remains intact. In this paper, we report a case of PPF in a female newborn infant associated with instrumental delivery, which was managed non-surgically with a vacuum extraction method. Because such a condition is uncommon and can be effectively managed with a relatively easy non-invasive method, this case is clinically interesting.
PopovVEMaiRB. [Depressed skull fractures in newborns. Case report of ping-pong fracture and literature review]. Zh Vopr Neirokhir Im N N Burdenko2022; 86(1): 96–102. DOI: 10.17116/neiro202286011962.
2.
IlhanOBorMYukkaldiranP. Spontaneous resolution of a “ping-pong” fracture at birth. BMJ Case Rep2018; 2018: bcr2018226264. DOI: 10.1136/bcr-2018-226264.
3.
PrestonDJacksonSGandhiS. Non-traumatic depressed skull fracture in a neonate or “ping pong” fracture. BMJ Case Rep2015; 2015: bcr2014207077. DOI: 10.1136/bcr-2014-207077.
4.
PollakLRazielAArielyS, et al.Revival of non-surgical management of neonatal depressed skull fractures. J Paediatr Child Health1999; 35(1): 96–97. DOI: 10.1046/j.1440-1754.1999.00327.x.
5.
ZalatimoORanasingheMGDiasMS, et al.Treatment of depressed skull fractures in neonates using percutaneous microscrew elevation. J Neurosurg Pediatr2012; 9(6): 676–679. DOI: 10.3171/2012.2.peds11304.
6.
DupuisOSilveiraRDupontC, et al.Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates. Am J Obstet Gynecol2005; 192(1): 165–170. DOI: 10.1016/j.ajog.2004.06.035.
TerviläLHuhmarEOKrokforsE. Cerebral birth injury as a cause of epilepsy. Ann Chir Gynaecol Fenn1975; 64(2): 118–122. https://pubmed.ncbi.nlm.nih.gov/806248/ (Accessed 23 March 2024).
9.
ReichardR. Birth injury of the cranium and central nervous system. Brain Pathol2008; 18(4): 565–570. DOI: 10.1111/j.1750-3639.2008.00205.x.
10.
PrevedelHMutzI. [Raising an impression fracture of the skull in the newborn infant with the vacuum extractor]. Monatsschr Kinderheilkd1985; 133(7): 488–489. https://pubmed.ncbi.nlm.nih.gov/4047062/ (Accessed 23 March 2024).
11.
SaundersBSLazoritzSMcArtorRD, et al.Depressed skull fracture in the neonate. J Neurosurg1979; 50(4): 512–514. DOI: 10.3171/jns.1979.50.4.0512.
12.
HanlonLHoganBCorcoranD, et al.Congenital depression of the neonatal skull: a self-limiting condition. Arch Dis Child Fetal Neonatal Ed2006; 91(4): F272. DOI: 10.1136/adc.2005.082347.
13.
Gloria Ogur Schrager. Elevation of depressed skull fracture with a breast pump. J Pediatr1970; 77(2): 300–301. DOI: 10.1016/s0022-3476(70)80340-7.
14.
López-ElizaldeRLeyva-MastrapaTMuñoz-SerranoJA, et al.Ping pong fractures: treatment using a new medical device. Childs Nerv Syst2012; 29(4): 679–683. DOI: 10.1007/s00381-012-1979-2.
15.
TannirandornYThaithumyanonPAroonrasmeruangT. Elevation of depressed skull fracture in the neonate by obstetrical vacuum extractor. J Medical Assoc Thailand = Chotmaihet Thangphaet1993; 76(12): 698–702. https://pubmed.ncbi.nlm.nih.gov/7798823/ (Accessed 23 March 2024).
16.
HungKLLiaoHTHuangJS. Rational management of simple depressed skull fractures in infants. J Neurosurg2005; 103(1): 69–72. DOI: 10.3171/ped.2005.103.1.0069.
17.
SteinbokPFlodmarkOMartensD, et al.Management of simple depressed skull fractures in children. J Neurosurg1987; 66(4): 506–510. DOI: 10.3171/jns.1987.66.4.0506.
18.
SunejaUProkhorovS. Depressed skull fracture in a term newborn infant. Pediatr Therapeuts2015; 5(4): 1000i109. DOI: 10.4172/2161-0665.1000i109.
19.
ChalmersJAFothergillRJ. Use of a vacuum extractor (ventouse) in obstetrics. BMJ1960; 1(5187): 1684–1689. DOI: 10.1136/bmj.1.5187.1684.
20.
HaymanRGilbyJArulkumaranS. Clinical evaluation of a “hand pump” vacuum delivery device. Obstet Gynecol2002; 100(6): 1190–1195. DOI: 10.1097/00006250-200212000-00008.
21.
IlhanOBorMYukkaldiranP. Spontaneous resolution of a “ping-pong” fracture at birth. BMJ Case Rep2018; 2018: bcr2018226264. DOI: 10.1136/bcr-2018-226264.
22.
BasaldellaLMartonEBekelisK, et al.Spontaneous resolution of atraumatic intrauterine ping-pong fractures in newborns delivered by cesarean section. J Child Neurol2011; 26(11): 1449–1451. DOI: 10.1177/0883073811410058.
23.
HanlonLHoganBCorcoranD, et al.Congenital depression of the neonatal skull: A self limiting condition. Arch Dis Child Fetal Neonatal Ed2006; 91(4): F272. DOI: 10.1136/adc.2005.082347.
24.
MillerHRWhiteJA. Ping-pong fractures of the skull in neonates: Clinical and radiological features. Pediatr Radiol2008; 38(1): 20–26.
