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Special article
DOI: 10.1016/j.neucie.2021.07.001
Available online 5 October 2021
A new, readily accessed and low-cost, device for treating depressed ping pong fractures non-surgically: Technical note
Un nuevo dispositivo, de fácil acceso y bajo costo para el tratamiento no quirúrgico de fracturas deprimidas en «ping pong»: Nota técnica
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Federico E. Minghinellia,
Corresponding author
minghinelli.f@gmail.com

Corresponding author.
, Rodolfo Recaldea, Mariano Socolovskya, Alfredo Houssayb,c
a División Neurocirugía, Hospital de Clínicas José de San Martín, Facultad de medicina UBA, Buenos Aires, Argentina
b División Neurocirugía, Maternidad Santa Rosa, Vicente López, Buenos Aires, Argentina
c División Neurocirugía, Hospital Británico, Buenos Aires, Argentina
Received 20 May 2021. Accepted 14 July 2021
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Abstract
Objective

The aim of this paper is to describe a low-cost and readily accessed Manual Aspiration Reduction System (MARS) for use treating ping-pong fractures in three patients.

Methods

The MARS is composed of a pediatric anesthesia mask, part of a macro dripper, a 3-way stopcock, and two 60-ml syringes. Prior to its use in our patient, the system was tested on five adult volunteers to maximum negative pressure, and none reported pain during the procedure or experienced any other complication.

We present three clinical cases of patients with depressed ping-pong fracture who were treated with the MARS at the bedside without anesthesia. The patients were monitored by the neonatology team throughout the procedure.

Results

Skull radiography revealed reduction of the fracture after the procedure performed with the MARS in all patients. The transfontanellar ultrasound and follow-up neurological examination were normal. The patient progressed favorably and was discharged from our service after 24 h.

Conclusions

Due to its components, the MARS is a low-cost and readily accessed system. In this case, it permitted satisfactory reduction of a ping-pong fracture in all patients. This system should greatly simplify the treatment of such fractures.

Keywords:
Fracture
Ping-pong
Aspiration
Treatment
Reduction
Resumen
Objetivo

El objetivo del trabajo es describir un sistema de reducción con aspiración manual de bajo costo y fácil acceso (SiRAMa) utilizado para tratar fracturas deprimidas en «ping pong» en 3 pacientes.

Método

El SiRAMa está compuesto por una máscara de anestesia pediátrica, parte de un macrogotero, una llave de 3 vías y 2 jeringas de 60 ml. Previamente a su utilización en los pacientes el sistema se testó en 5 voluntarios adultos utilizando su máxima potencia, los cuales no refirieron dolor durante el procedimiento ni presentaron otra complicación.

Presentamos 3 casos clínicos de pacientes con fractura deprimida en «ping pong», los cuales fueron tratados con el SiRAMa al lado de la cama sin anestesia. Los pacientes fueron monitorizados por el equipo de neonatología durante todo el procedimiento.

Resultados

La radiografía de cráneo evidenció la reducción de la fractura tras el procedimiento realizado con el SiRAMa en todos los pacientes. La ecografía transfontanelar y el examen neurológico de control fueron normales. Los pacientes evolucionaron favorablemente y fueron dados de alta a las 24 horas.

Conclusiones

Debido a sus componentes el SiRAMa es un sistema de bajo costo y fácil acceso. En este caso permitió la reducción satisfactoria de la fractura en «ping pong» en todos los pacientes. Este sistema permitiría simplificar el tratamiento de las fracturas de este tipo que así lo requieran.

Palabras clave:
Fractura
Ping-pong
Aspiración
Tratamiento
Reducción

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