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January 26, 1976

latrogenic Skull Fracture Depression By Use of a Head Clamp

Author Affiliations

From the Neurological Unit, Boston City Hospital, and the Department of Neurology, Harvard Medical School, Boston.

JAMA. 1976;235(4):414-415. doi:10.1001/jama.1976.03260300040031

SKULL roentgenograms are obtained in most cases of severe head trauma reaching emergency medical facilities. This practice persists despite evidence of the questionable value of these studies in patients not reasonably suspected of having depressed fractures or foreign body penetration of scalp or skull.1,2

When the head trauma victims are young children or infants unable to cooperate with diagnostic roentgenographic procedures, adequate films often require head fixation. Metal foam-padded head clamps are now commonly used for head immobilization during routine roentgenography as well as radioisotope brain scanning.3

We report a case in which depression of a fracture edge shown by an anteroposterior roentgenogram was caused by lateral head-compression applied by means of a standard restraining clamp. Because of the central location of this iatrogenic depression, a surgical exploration was done.

Report of a Case  A 6-week-old male infant was admitted to Boston City Hospital on Aug 12, 1974,