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BCA News: Summer 2018

Dr. Afzal Ansary, FBPAPond Fracture of the Skull: Story Behind the Image

Dr. Afzal Ansary, FBPA

Fractures of the Skull

There are different types of skull fractures and these are usually result of significant force to the head. Some studies indicate that as much as 235 kg (520 pounds) or 2,300 newtons of force would be needed to crush a human skull. Fractures of the skull also depend on a direct force being applied to the skull, surface area of the force, velocity of the force, point of the impact, and the age of the person. Most of the major skull fractures are the result of heavy blunt force trauma caused by, such as, hammer, rock or being kicked by a horse. These can cause bleeding from the wound and near the location of the injury, or around ears, eyes and nose as well. There are four major types of skull fractures: basilar, diastatic, linear and depressed. Skull fractures which are depressed are usually showing fragmented bones displayed inwards. Pond fracture is caused by a depression of the skull causing inner buckling of the fragmented bones like ripples effect on a pond.

Story Behind the Image

It was a Saturday afternoon and as usual I was playing weekly golf competition at my local golf club. After the game and short socialising with friends I headed home. At around 8:00pm I had a phone call from a neurosurgeon at the teaching hospital where I worked as head of the department of medical photography. I knew the neurosurgeon well, in fact, he was a friend as well. He explained that he had an interesting case of Pond Fracture of the skull on the operating table and wanted some intraoperative images.

I rushed to my office at the hospital and picked my camera gear and headed straight into the OR. As soon as I saw the patient I recognised him as one of the four golf players playing in front of us earlier in afternoon at the golf club. I took this intra-operative image and several others until the wound was fully repaired and sutured.

Pond Fracture © Afzal Ansary
Pond Fracture © Afzal Ansary

Later on, I found out that there was a dispute on the score and he (the patient) was clobbered by his opponent with a gold club, a driver, with full impact causing major injury to the head. He was rushed by an ambulance to the hospital where I worked.

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