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Depressed skull fracture in Ping Pong: elevation with Medeva extractor

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Abstract

Introduction

The bones of the skull of the newborn and nursing infants, in general, possess great malleability. For this reason, the depressed fractures occurring at this age are called “Ping Pong” or “Green Stick” fractures. The treatment of these fractures is surgical according to different authors, although some of these fractures that happen in childbirth can elevate themselves spontaneously.

Technique

A breast milk extractor trade mark “MEDEVA” was used for the procedure in newborns with a depression larger than 2 cm in diameter. Minimal aspiration was performed while observing the elevation through the transparent breast milk extractor MEDEVA until the depression elevated without leaving any trace.

Discussion

The aspiration procedure was satisfactory and curative in the five children treated. The fracture was successfully elevated and the skull returned to its normal position and configuration without complications for the patients.

Conclusion

Finally, it has been demonstrated that this procedure is simple, inexpensive, and avoids surgical intervention.

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References

  1. Bhat BV, Kumar A, Oumachigui A (1994) Bone injuries during delivery. Indian J Pediatr 61(4):401–405

    PubMed  CAS  Google Scholar 

  2. Captier G, Lebarazer M, Bigorre M, Leboucq N, Montoya P (1999) Congenital skull depression. Report of 2 cases. Ann Chir Plast Esthet 44(3):266–271 (Article in French)

    PubMed  CAS  Google Scholar 

  3. Curry DJ, Frim DM (1999) Delayed repair of open depressed skull fracture. Pediatr Neurosurg 31(6):294–297

    Article  PubMed  CAS  Google Scholar 

  4. Dupuis O, Silveira R, Redarce T, Dittmar A, Rudigoz RC (2003) Instrumental extraction in 2002 in the “AURORE” hospital network: incidence and serious neonatal complications. Gynecol Obstet Fertil 31(11):920–926 (Article in French)

    Article  PubMed  CAS  Google Scholar 

  5. Ersahin Y, Mutluer S, Mirzai H, Palali I (1996) Pediatric depressed skull fractures: analysis of 530 cases. Childs Nerv Syst 12(6):323–331

    Article  PubMed  CAS  Google Scholar 

  6. Govaert P, Vanhaesebrouck P, De Praeter C, Moens K, Leroy J (1992) Vacuum extraction, bone injury and neonatal subgaleal bleeding. Eur J Pediatr 151(7):532–535

    Article  PubMed  CAS  Google Scholar 

  7. Harpold TL, McComb JG, Levy ML (1998) Neonatal neurosurgical trauma. Neurosurg Clin N Am 9(1):141–154

    PubMed  CAS  Google Scholar 

  8. Hes R, de Jong TH, Paz y Geuze DH, Avezaat CJ (1997) Rapid evolution of a growing skull fracture after vacuum extraction in case of fetal hydrocephalus. Pediatr Neurosurg 26(5):269–274

    Article  PubMed  CAS  Google Scholar 

  9. Hickey K, McKenna P (1996) Skull fracture caused by vacuum extraction. Obstet Gynecol 88(4 Pt 2):671–673

    Article  PubMed  CAS  Google Scholar 

  10. Lim CT, Koh MT, Sivanesaratnam V (1991) Depressed skull fracture in a newborn successfully managed conservatively: a case report. Asia Oceania J Obstet Gynaecol 17(3):227–229

    PubMed  CAS  Google Scholar 

  11. Martinez-Lage Sanchez JF, Poza Poza M, Almagro Navarro MJ, Rodriguez Costa T, Casas Fernandez C, Puche Mira A (1991) Depressed skull fracture in the newborn infant. To operate or not? An Esp Pediatr 35(1):7–11 (Article in Spanish)

    PubMed  CAS  Google Scholar 

  12. Nadas S, Gudinchet F, Capasso P, Reinberg O (1993) Predisposing factors in obstetrical fractures. Skeletal Radiol 22(3):195–198

    Article  PubMed  CAS  Google Scholar 

  13. Paul MA, Fahner T (1991) Closed depressed skull fracture in childhood reduced with suction cup method: case report. J Trauma 31(11):1551–1552

    Article  PubMed  CAS  Google Scholar 

  14. Pollak L, Raziel A, Ariely S, Schiffer J (1999) Revival of non-surgical management of neonatal depressed skull fractures. J Paediatr Child Health 35(1):96–97

    Article  PubMed  CAS  Google Scholar 

  15. Tannirandorn Y, Thaithumyanon P, Aroonrasmeruang T (1993) Elevation of depressed skull fracture in the neonate by obstetrical vacuum extractor. J Med Assoc Thai 76(12):698–702

    PubMed  CAS  Google Scholar 

  16. Tysvaer A, Nysted A (1994) Depression fractures of the skull in newborn infants. Treatment with vacuum extractor. Tidsskr Nor Laegeforen 114(28):3315–3316 (Article in Norwegian)

    PubMed  CAS  Google Scholar 

  17. Ubhi T, Reece A, Craig A (2000) Congenital skull fracture as a presentation of Menkes disease. Dev Med Child Neurol 42(5):347–348

    Article  PubMed  CAS  Google Scholar 

  18. Vidal Mico S, Lopez Navarro MC, Tellez de Meneses M, Alvarez Garijo JA, Perez Aytes A (2001) Spontaneous resolution of a congenital depressed skull fracture. An Esp Pediatr 54(1):78–80 (Article in Spanish)

    PubMed  CAS  Google Scholar 

  19. Wheeler DS, Shope TR (1997) Depressed skull fracture in a 7-month-old who fell from bed. Pediatrics 100(6):1033–1034

    Article  PubMed  CAS  Google Scholar 

Download references

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Correspondence to Tania Leyva Mastrapa.

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Mastrapa, T.L., Fernandez, L.A., Alvarez, M.D. et al. Depressed skull fracture in Ping Pong: elevation with Medeva extractor. Childs Nerv Syst 23, 787–790 (2007). https://doi.org/10.1007/s00381-007-0354-1

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  • DOI: https://doi.org/10.1007/s00381-007-0354-1

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