Pediatric ping-pong skull fractures treated with vacuum-assisted elevation.

Autor: Ahmed SD; Division of Neurosurgery, Children's Hospital of Orange County (CHOC), CHOC Neuroscience Institute, Orange, CA, USA., Allhusen VD; Division of Neurosurgery, Children's Hospital of Orange County (CHOC), CHOC Neuroscience Institute, Orange, CA, USA., Muhonen MG; Division of Neurosurgery, Children's Hospital of Orange County (CHOC), CHOC Neuroscience Institute, Orange, CA, USA.; Department of Neurosurgery, University of California Irvine Medical Center, Irvine, CA, USA., Magge SN; Division of Neurosurgery, Children's Hospital of Orange County (CHOC), CHOC Neuroscience Institute, Orange, CA, USA. smagge@med.umich.edu.; Department of Neurosurgery, University of California Irvine Medical Center, Irvine, CA, USA. smagge@med.umich.edu.; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA. smagge@med.umich.edu.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Jun; Vol. 40 (6), pp. 1833-1838. Date of Electronic Publication: 2024 Feb 27.
DOI: 10.1007/s00381-024-06307-w
Abstrakt: Purpose: Depressed ("ping-pong") skull fractures can be treated by different means, including observation, non-surgical treatments, or surgical intervention. The authors describe their experience with vacuum-assisted elevation of ping-pong skull fractures and evaluate variables associated with surgical outcomes.
Methods: The authors present a retrospective review of all ping-pong skull fractures treated with vacuum-assisted elevation at the Children's Hospital of Orange County in 2021-2022. Variables included patient age, mechanism of injury, fracture depth, bone thickness at the fracture site, and degree of elevation.
Results: Seven patients underwent vacuum-assisted elevation of ping-pong fractures at the bedside without the use of anesthesia. Fractures caused by birth-related trauma were deeper than those caused by falls (p < 0.001). There was no significant difference between groups in bone thickness at the fracture site (2.10 mm vs 2.16 mm, n.s). Six of the seven patients experienced significant improvement in fracture site depression, with four displaying a complete fracture reduction and two displaying a significant reduction. The degree of fracture reduction was modestly related to the depth of fracture, with the two deepest fractures failing to achieve full reduction. Age appeared to be related to fracture reduction, with the lowest reduction observed in one of the oldest patients in this sample. No complications were observed in any patient other than temporary mild swelling at the suction site, and no re-treatment or surgery for the fractures was required.
Conclusion: Vacuum-assisted elevation of ping-pong skull fractures is a safe and effective noninvasive treatment option for infants that can be used under certain circumstances. The procedure can be done safely at the bedside and is a relatively quick procedure. It avoids the need for open surgical intervention, anesthesia, or hospital admission, and can lead to excellent outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: