Ping pong skull fracture
Citation, DOI, disclosures and article data
Citation:
Ranwaka A, Glick Y, Ranchod A, et al. Ping pong skull fracture. Reference article, Radiopaedia.org (Accessed on 25 Mar 2025) https://doi.org/10.53347/rID-26777
rID:
26777
Article created:
7 Jan 2014,
Abhinav Ranwaka
Disclosures:
At the time the article was created Abhinav Ranwaka had no recorded disclosures.
View Abhinav Ranwaka's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Yaïr Glick had no financial relationships to ineligible companies to disclose.
View Yaïr Glick's current disclosures
Revisions:
19 times, by
11 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Pond fracture
- Ping pong fracture
- Ping pong fracture of skull
- Pond fracture of the skull
- Pond fractures
- Ping pong fractures
- Neonatal depressed skull fracture
- Neonatal depressed skull fractures
Ping pong skull fracture or pond skull fracture refers to a depressed skull fracture of the infant skull caused by inner buckling of the calvarium. It is seen in newborns because of the soft and resilient nature of their bones (like greenstick fractures of long bones) and the fracture line is not visualised radiologically.
On this page:
Clinical presentation
A shallow trench is noted on the surface of the skull, and the periosteum and dura are intact. Usually, it is not associated with significant neurological injury.
Pathology
It could occur both as birth trauma or due to postnatal blunt trauma. In the former, it usually results from the pressure caused by mother's pelvic bones against the soft skull during labour. Forceps used during delivery could also be a cause.
Radiographic features
May be seen as a smooth inward indentation of the calvarium. A distinct fracture line is not seen.
Treatment and prognosis
It can be either treated conservatively or surgically, depending on the severity of depression.
Spontaneous elevation has been described in ping pong fractures that occurred after birth trauma, however, it is extremely rare in infants after head trauma 4.
History and etymology
The fracture is called a 'ping pong' fracture because it resembles a ping pong ball that has been indented inwards with a finger.
Differential diagnosis
Imaging differential considerations include:
References
- 1. Zalatimo O, Ranasinghe M, Dias M et-al. Treatment of depressed skull fractures in neonates using percutaneous microscrew elevation. J Neurosurg Pediatr. 2012;9 (6): 676-9. doi:10.3171/2012.2.PEDS11304 - Pubmed citation
- 2. Zia Z, Morris AM, Paw R. Ping-pong fracture. Emerg Med J. 2007;24 (10): 731. doi:10.1136/emj.2006.043570 - Free text at pubmed - Pubmed citation
- 3. Cizmeci MN, Kanburoglu MK, Cemil B et-al. Ping pong fracture in the newborn: illustration of a case. Acta Neurol Belg. . doi:10.1007/s13760-012-0172-4 - Pubmed citation
- 4. Sorar M, Fesli R, Gürer B et-al. Spontaneous elevation of a ping-pong fracture: case report and review of the literature. Pediatr Neurosurg. 2012;48 (5): 324-6. doi:10.1159/000351412 - Pubmed citation
- 5. Brittain C, Muthukumar P, Job S, Sanka S. 'Ping pong' fracture in a term infant. BMJ case reports. doi:10.1136/bcr.01.2012.5631 - Pubmed
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Cases:
- Ping pong fracture
- Ping pong skull fracture
- Orbital venous varix
- Ping pong skull fracture
- Ping-pong skull fracture
- Ping pong fracture
- Ping pong fractures
- Cephalohaematoma
- Skull fracture
- Ping pong skull fracture
- Ping pong skull fracture
- Ping pong skull fracture
- Ping pong skull fracture
- Ping pong skull fracture
- Ping pong fracture of the skull
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