Abstract
To compare various obstetrical methods with different types of obstetrical fractures, 29 neonates with fractures were evaluated retrospectively. Plain films of skull, limbs and chest were obtained. Transfontanellar ultrasonography was performed in one case and a computed tomographic scan of the skull in two. We reviewed 12 fractures of long bones, 7 fractures of the skull, and 10 fractures of the clavicle. Ten fractures occurred during caesarean sections and 11 in vaginal delivery requiring medical assistance. Depressed skull fractures were associated with manoeuvres and the use of forceps during delivery. Fractures of the long bones were associated with caesarean section, breech delivery with assistance and low birth weight. All fractures were treated conservatively except for skull fractures with depression of more than 2 cm. Early consolidation occurred in all fractures of long bones. The long-term follow-up of all fractures but one revealed no persisting disability. The belief that obstetrical fractures occur primarily in large babies or after breech delivery is not supported by this study.
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References
Banagale RC (1983) Neonatal fracture and caesarean section. Am J Dis Child 137:505
Barbieri E, Fossatti E, Ghiringhelli C (1971) Osservazioni sulle fratture ostetriche della diafisi del femore. Minerva Ortop 22:225–236
Barbieri E, Ghiringhelli C, Fossatti E (1971) Sulle fratture ostetriche della diafisi omerale. Minerva Ortop 22:292–297
Camus M, Lefebvre G, Veron P, Darbois Y (1985) Traumatismes obstétricaux du nouveau-né, enquête rétrospective á propos de 20409 naissances. J Gynecol Obstet Biol Reprod (Paris) 14:1033–1044
Cohen AW, Otto SR (1980) Obstetric clavicular fractures: a three-year analysis. J Reprod Med 25:119–122
Hägglund G, Hansson LI, Wiberg G (1988) Correction of deformity after femoral birth fracture: 16-year follow-up. Acta Orthop Scand 59:333–335
Hensinger RN, Jones ET (1981) Neonatal orthopaedics. Grune & Stratton, New York, pp 33–50
Joseph PR, Rosenfeld W (1990) Clavicular fractures in neonates. Am J Dis Child 144:165–167
Kaplan M, Dollberg M, Wajntraub G, Itzchaki M (1987) Fractured long bones in a term infant delivered by cesarian section. Pediatr Radiol 17:256–257
Katz R, Landman J, Dulitzky F, Bar-Ziv J (1988) Fracture of the clavicle in the newborn. An ultrasound diagnosis. J Ultrasound Med 7:21–23
Kellner KR (1982) Neonatal fracture and caesarean section. Am J Dis Child 136:865
Levine MG, Holroyde J, Woods JR, Siddiqi TA, Scott MH, Miodovnik M (1984) Birth trauma: incidence and predisposing factors. Obstet Gynecol 63:792–795
Loeser JD, Kilburn HL, Jolley T (1976) Management of depressed skull fracture in newborn. J Neurosurg 44:62–64
Madsen ET (1955) Fractures of extremities in the newborn. Acta Obstet Gynecol Scand 34:41–73
Natelson SE, Sayers MP (1973) The fate of children sustaining severe head trauma during birth. Pediatrics 51:169–174
Neiger R, Sacks LM (1988) An unusual neonatal case presentation. J Perinatol 8:160–162
Raynor R, Parsa M (1968) Nonsurgical elevation of depressed skull fracture in an infant. J Pediatr 72:262–264
Rubin A (1964) Birth injuries: incidence, mechanisms, and end results. Obstet Gynecol 23:218–221
Salonen IS, Uusitalo R (1990) Birth injuries: incidence and predisposing factors. Z Kinderchir 45:133–135
Saunders BS, Lazoritz S, McArtor RD, Marshall P, Bason WM (1976) Depressed skull fracture in neonate. Report of three cases. J Neurosurg 50:512–514
Schrager GO (1970) Elevation of depressed skull fracture with breast pump. J Pediatr 77:300–331
Steinbok P, Flodmark O, Martens D, Germann ET (1987) Management of simple depressed skull fractures in children. J Neurosurg 66:506–510
Tavarez LA, Kottamasu SR, Ezhuthachan SG, Katz ME (1989) Neonatal skull depression: review of four cases. J Perinatol 9:423–426
Tittel K (1981) Rotational deformities of the femur shaft fractures in children, their development and treatment. In: G. Chapchal (ed) Fractures in children. Thieme, Stuttgart, pp 52–53
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Nadas, S., Gudinchet, F., Capasso, P. et al. Predisposing factors in obstetrical fractures. Skeletal Radiol. 22, 195–198 (1993). https://doi.org/10.1007/BF00206153
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DOI: https://doi.org/10.1007/BF00206153