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Case Reports
. 2018 Sep 23:2018:bcr2018226264.
doi: 10.1136/bcr-2018-226264.

Spontaneous resolution of a 'ping-pong' fracture at birth

Ozkan Ilhan  1 , Meltem Bor  1 , Pinar Yukkaldiran  2
Affiliations
Case Reports

Spontaneous resolution of a 'ping-pong' fracture at birth

Ozkan Ilhan et al. BMJ Case Rep. .

Abstract

'Ping-pong' fractures are depressed skull fractures in newborn infants that occur as inward buckling of the calvarial bones, forming a cup shape. These fractures are often associated with maintenance of bone continuity. These fractures may occur spontaneously during the intrauterine period or secondary to birth trauma. Currently, there is no standard protocol for the management of depressed skull fractures. Neurosurgical or non-surgical approaches may be administered depends on the severity of the fracture. Most untreated ping-pong fractures resolve spontaneously within 6 months. Therefore, it is recommended to reserve surgical elevation or non-surgical techniques for infants not demonstrating spontaneous resolution during this period. In addition, neurosurgical interventions are usually considered for cases with intracranial pathology or neurological deficits or for infants who do not respond to conservative treatment. Herein, we report a case of a newborn infant with a spontaneous intrauterine ping-pong fracture, which spontaneously resolved, without surgical or non-surgical intervention.

Keywords: anaesthesia; neonatal health; neuroimaging; neurosurgery; trauma CNS /PNS.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Photography of the newborn after birth showed the right parietal depression of the skull (arrow).
Figure 2
Figure 2
Axial CT scan showed depression of the right parietal area of the skull (arrow) without intraparenchymal injury.
Figure 3
Figure 3
Three-dimensional CT reconstruction revealed the invagination of the parietal bone with no evidence of break line (arrow).
See this image and copyright information in PMC

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