Congenital Depressed Skull Fracture Lifting with Suction Cup: A Therapeutic Alternative to Surgery

Abstract

Congenital skull fractures of newborn are rare and create medico-legal problems. Their management is controversial. Between surgery considered too aggressive and uncertain conservative attitude, reduction by suction cup or breast pump is an alternative. The authors report their experience through a case of successful resolution of a congenital depressed skull fracture using a suction cup in a newborn at 13 day of life followed by a literature review. This technique avoids the usual complications of surgery and reduces the anxiety of parents related to surgery. It also avoids the anxiety of having a newborn with a recessed skull and a conservative attitude with uncertain outcome.

Successful Non-Operative Treatment of Congenital ‘Pin-Pong’ Fracture in a Newborn Delivered by Caesarean Section

“…They are forms of green stick fracture [2]. The incidence of congenital pin-pong fracture is 1 to 2.5 per 10,000 live births [2,6,7]. Congenital pin-pong fracture is an extremely rare condition with limited reports in the absence of trauma in literature [1,[8][9][10][11].…”

“…To the best of our knowledge this is the first report in Nigeria. Usually, pin-pong fracture occurs following head trauma during complicated deliveries such as instrumental or with obstetric manoeuvres or from abdominal trauma in pregnancy in extremely uncommon cases, it occurs with no identifiable trauma or any other aetiology [2,6,12].…”

“…The proposed mechanism of congenital pin-pong fracture is persistent intrauterine pressure on the soft, malleable skull caused by bony structures such as sacral promontory, pelvic symphysis, 5 th lumbar vertebra or ischial bone or even by fetal extremities [2,3,6]. Also, fetal head pressure against maternal pelvic mass like fibroid or tumour may results in pin-pong fracture [3].…”

“…Cranial computerised tomography scan is the preferred imaging modality in evaluation of bone abnormality like pin-pong fracture [13]. The treatment of pin-pong fracture remains controversial [3,6]. Both non-operative and operative modalities were described depending on the neurological status of the patient and radiological characteristics of the depression.…”

“…Both non-operative and operative modalities were described depending on the neurological status of the patient and radiological characteristics of the depression. [1,6,13,14] The objective of this paper was to report a successful treatment of congenital pin-pong fracture in a New-born using a watchful waiting strategy.…”