Abstract
Femoral shaft fracture following birth in newborns is a very rare injury. However, the risk factors for, mechanism of and management of these injuries remain a matter of debate. We describe our observations in a tertiary centre. Ten cases of femoral shaft fracture encountered during a study period from January 2005 to December 2009 were evaluated. The demographic details, risk factors during birth, systemic illness, mode of delivery, type of fracture and management used were documented, and an analysis was performed. Mean gestational age was 37.2weeks. Mean time to diagnose was 4days. Two patients had subtrochanteric fracture, and eight patients had mid-shaft fracture. Most patients had breech presentation and had been born by Caesarean section. All patients showed complete union at the end of 4weeks. No residual angulation or limb length discrepancy was noted after mean follow-up of 5years. Thorough clinical examination and proper orthopaedic consult in the event of doubtful presentation help in early diagnosis and management. These fractures have good prognosis at long-term follow-up.
Highlights
The risk factors for, mechanism of and management of these injuries remain a matter of debate
Ten cases of femoral shaft fracture encountered during a study period from January 2005 to December 2009 were evaluated
Birth injuries occurring due to trauma during the process of childbirth are very rare [1]
Summary
Birth injuries occurring due to trauma during the process of childbirth are very rare [1]. They are a cause of significant neonatal morbidity despite improved obstetric and perinatal care, more so in developing countries. The spectrum of birth injuries includes a simple bruise, swelling, forceps scar or loss of nerve and motor function or rarely a fracture. An estimated three-quarters of all long-bone fractures during birth are ascribed to vaginal breech deliveries [2]. Other risk factors include low birth weight and large foetus. Though numerous reports regarding femoral shaft fracture have been published, the associated risk factors, characteristics and treatment modalities have not been well elucidated. Our present study, consisting of a case series of ten newborns with fracture of femur, aims to throw light on its associated factors and treatment strategies
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