Bilateral Humerus Fractures in a New-Born During a Caesarean Delivery: Case Report and Critical Review of the Literature

Abstract

Purpose: To analyse clinical case of neonatal bilateral humerus fractures, which represent a very rare event in births by caesarean section. Method: We analysed the case of a newborn with a bilateral humerus fractures associated with a caesarean delivery in the Paediatric Intensive Care Unit of our centre. The infant was delivered premature at seven and a half months, weighed 1,100g, was 33.4 cm in length and was born by caesarean section performed on a primiparous mother in non-urgent conditions. The extraction of the newborn was hampered by the entrapment of the head. The new-born's family history was negative for cases of osteogenesis imperfecta or other osteo-metabolic genetic diseases. The treatment adopted was a partial reduction and immobilization under sedation. The radiographic follow-up performed at 4 weeks showed a bone remodelling with good alignment of the axis. From a clinical point of view, the newborn had neither deficits nor residual deformities. Results: The main risk factors are: prematurity, low birth weight, foetal malposition, uterine defects, first pregnancy, delivery in conditions of emergency and iatrogenic birth traumas. In these cases, it is important to exclude the possibility of pathologies of an osseous or chromosomal nature. Conclusion: It is essential to immediately dispel any doubts regarding the possibility of osseous or chromosomal disorders. The careful management of the medical-parent relationship is important in order to best handle parental anxiety and avoid the potential risk of unnecessary medical disputes.