Article Data

  • Views 2261
  • Dowloads 168

Original Research

Open Access

“Spontaneous” ping-pong fracture in newborns: case report and review of the literature


1Department of Pediatrics, Catholic University of Sacred Heart

2Pediatric Neurosurgery, Catholic University of Sacred Heart

DOI: 10.22514/SV101.042015.11 Vol.10,Issue 1,April 2015 pp.103-109

Published: 30 April 2015

*Corresponding Author(s): CLAUDIA FANTACCI E-mail:


“Ping-pong” fractures (PPF) are depressed skull fractures typical of newborns. PPF usually result from head injury and, rarely, may cause severe long-term neurological sequelae. The management of PPF is still controversial. The goal of this paper is to present a case of “spontaneous” ping-pong fracture and to review the pertinent literature of the last 20 years. We report on a newborn who presented with a “spontaneous” parietal depressed skull fracture at birth. Preoperative computed tomography (CT) scan confirmed the PPF and excluded brain injuries. Neurosurgical intervention was performed on day 3 with immediate lifting of the fracture; the postoperative course was uneventful.

During the last 20 years, 22 cases of “spontaneous ping-pong” fractures in newborn have been reported, with different clinical pictures and management but, generally, with a good outcome.

“Ping-pong” fractures can occur in uneventful pregnancies and after uncomplicated vaginal or cesarean deliveries. CT scan, with low-dose protocol for infants, is the gold standard examination to evaluate the fracture and any associated brain lesions. Treatment is selected according to fracture characteristics.


ping-pong fracture, newborns, CT scan, delivery, neurosurgery

Cite and Share

CLAUDIA FANTACCI,LUCA MASSIMI,DOMENICO CAPOZZI,VALERIO ROMANO,PIETRO FERRARA,ANTONIO CHIARETTI. “Spontaneous” ping-pong fracture in newborns: case report and review of the literature. Signa Vitae. 2015. 10(1);103-109.


1. Mastrapa TL, Fernandez LA, Alvarez MD, Storrs BB, Flores-Urueta A. Depressed skull fracture in Ping Pong: elevation with Medeva extractor. Childs Nerv Syst 2007;23:787-90.

2. Zalatimo O, Ranasinghe M, Dias M, Iantosca M. Treatment of depressed skull fractures in neonates using percutaneous microscrew elevation. J Neurosurg Pediatr 2012;9:676-9.

3. Dupuis O, Silveira R, Dupont C, Mottolese C, Kahn P, Dittmar A, et al. Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates. Am J Obstet Gynecol 2005;192:165-70.

4. Natelson SE, Sayers MP. The fate of children sustaining severe head thrauma during birth. Pediatrics 1973;51:169-74.

5. Aliabadi H, Miller J, Radnakrishnan S, Mehta AI, Thomas K, Selznick L, et al. Spontaneous intrauterine “ping-pong” fracture: review and case illustration. Neuropediatrics 2009;40:73-5.

6. Chiaretti A, De Benedictis R, Della Corte F, Piastra M, Viola L, Di Rocco C. The impact of initial management on the outcome of children with severe head injury. Child’s Nervous System 2002;18:54-60.

7. Basaldella L, Marton E, Bekelis K, Longatti P. Spontaneous resolution of atraumatic intrauterine ping-pong fractures in newborns delivered by cesarean section. J Child Neurol 2011;26:1449-51.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time