A 7-week-old baby boy involved in a road traffic accident was brought to the accident and emergency department. A right-sided skull depression was palpated during the secondary survey. An emergency computed tomographic scan showed a depression of the parietal bone with no fracture line (fig 1). The patient was transferred to a paediatric neurosurgical centre where the indentation was lifted surgically.

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Figure 1 Computed tomographic scan showing a depression of the parietal bone with no fracture line in a 7-week-old baby boy.

Ping-pong fracture occurs in newborn and young infants, when the skull is relatively very soft and resilient and is able to indent without a break in the bone. It is so called due to its similarity to indentation produced on a ping-pong ball. Ping-pong fractures have been described in birth injuries, and accidental and non-accidental injuries.1 They are seldom associated with intracranial injury. It can be treated conservatively or surgically depending upon the severity of depression.