- A baby was born with a depressed skull fracture that could have caused neurological damage.
- He didn't have surgery because his medical team thought of a unique way to treat the fracture.
It's rare for babies to be born with a depressed skull fracture. But when it occurs, they're routinely taken to the operating room.
But an enterprising medical team has invented a surprising nonsurgical technique to repair the skull of an infant.
They put a breast pump on the dented part of his head to "suck" the bone into place. The boy, named Elliot, has gone on to thrive. Three months after the procedure, which took place he was one day old, he is a happy and healthy child.
Emilie Martinez, a physician assistant at Children's Memorial Hermann in Houston, came up with the idea of using the breast pump. She'd recently read an article in a journal about the way that obstetric pumps might be used to help solve the problem.
But she said the suction that's used to assist in the last stages of labor can sometimes be indelicate. "We wanted something more gentle," Martinez told Insider.
She went back and forth on a solution and hit on the unconventional breast-pump method.
Dr. David Sandberg, a pediatric neurosurgeon at the same hospital, said he was impressed by his colleague's "creativity."
"We're always looking for innovative ways to treat children," he said. "And we're always looking for possible ways to avoid surgery."
Martinez said she asked a lactation consultant if she could borrow a hospital-grade breast pump from the labor and delivery floor. "I told her that we were about to try this crazy thing," Martinez said.
The physician assistant found the right level of suction to reverse the damage to the skull
Martinez, the lead PA in Sandberg's unit, told Insider that she used a kind of "putty" to put a seal on the funnel-shaped cup. The material is frequently used for ostomies.
She said that she molded it to fit the contour of Elliot's fracture. Then, Martinez said, she tried out the settings on the breast pump to find the right level of suction.
"I experimented quite a lot," Martinez said. "I used it on the fleshy palm of my hand so that I could feel how much suction there was" or if it caused bruising.
Sandberg told Insider that medical professionals refer to a depressed skull fracture as a "ping-pong fracture." He said that the skull could be compared to a table-tennis ball that had been "dented by a thumb."
"By putting the suction device right over the ping-pong fracture, it sucks the bone into place," the physician said. "There may still be a linear fracture line, but it will heal on its own."
Sandberg and Martinez applied the breast-pump technique to a baby last year, so they were confident that Elliot's procedure would also work.
It did. Sandberg did the procedure while Martinez held the suction cup to Elliot's head. His skull was quickly repaired.
Sandberg said it was unusual for babies to suffer a depressed skull fracture in utero. "They have a very fragile skull and it might just have been bad luck," the specialist said.
He said that the injury is more likely to happen after birth as a result of trauma like a car accident or being dropped. Babies who are older may need more involved surgery because their skulls can be "less pliable," the doctor said.
"In Elliot's case, the fracture was causing local pressure on the brain with uncertain consequences," Sandberg said. "There could always be seizures, which can happen from any cause of irritation of the brain, or some other neurological problem."
"But we weren't going to let it get that far," he added.
Martinez told Insider that she had found their breast-pump strategy particularly intriguing because she had a young baby herself. "I am exclusively breastfeeding and pumping," Martinez, whose son is 10 months old, said. "I was much more familiar with breast pumps and the way that the suction works."
"I owe my own son a little bit of credit for adding to my knowledge," she said.
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