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Emerg Med J. 2007 October; 24(10): 731.
PMCID: PMC2658448

Ping‐pong fracture

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 11).). The patient was transferred to a paediatric neurosurgical centre where the indentation was lifted surgically.

figure em43570.f1
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.


Competing interests: None declared.


1. Wheeler D S, Shope T R. Depressed fracture in a 7‐month‐old who fell from bed. Paediatrics 1997. 1001033–1034.1034 [PubMed]

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