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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.
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.
This article has been adapted from Zia Zergham, Morris Ann-Marie, Paw Rajan. Ping-pong fracture Emergency Medicine Journal 2007;24:731
Competing interests: None declared.
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