Delayed Birth-Related Femur Fracture after Cesarean Section: A Case Report

Kanai, Yuji; Honda, Yoshinobu; Honda, Tsuyoshi; Sanpei, Minoru

doi:10.1055/s-0038-1667190

Cited by 10 publications

(10 citation statements)

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“…Delayed diagnosis, after discharge, has previously been reported for clavicle fractures in 13%‐39%, and mean duration to diagnosis of femur fractures has been reported to be 6.3 days; in one case, the diagnosis was made on day 9, indicating that non‐dislocated birth‐related fractures are not easily diagnosed . Clavicle fractures diagnosed later during the neonatal period had similar risk factors as the birth‐related clavicle fractures.…”

Section: Discussionmentioning

confidence: 99%

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

et al. 2020

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Aim Specific birth‐related fractures have been studied; underestimates might be a problem. We aimed to assess all fractures diagnosed as birth‐related as well as other neonatal fractures. Methods A population‐based study on all infants born in Sweden 1997‐2014; data were retrieved from the Swedish Health Registers (10th version of International Classification of Diseases. Outcome measures were birth‐related fractures (ICD‐10 P‐codes) and other neonatal fractures (ICD‐10 S‐codes). Results The overall fracture incidence was 2.9 per 1000 live birth (N = 5336); 92.6% had P‐codes and 7.4% (S‐codes). Some birth‐related fractures were diagnosed beyond the neonatal period. Other neonatal fractures could have been birth‐related. Clavicle fracture (88.8%) was associated with adverse maternal and infant anthropometrics and birth complications. The few neonates with rib fractures all had concomitant clavicle fracture. For skull fractures, a minor part was birth‐related and most were associated with accidents. Half of the long bone fractures were associated with accidents. Birth‐related femur fractures were associated with bone fragility risk factors. Five infants with abuse diagnoses had fractures: skull (4), long bone (2) and rib (1). Conclusion Birth‐related and other neonatal fractures are rarely diagnosed. Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures.

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Section: Discussionmentioning

confidence: 99%

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

et al. 2020

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“…Swelling of the leg, lack of motion, and discomfort when changing diapers are the most common signs [ 7 ]. Neonates delivered by Caesarean section in the breech presentation should be closely monitored after birth [ 8 ]. Fracture diagnosis is typically based on a clinical review.…”

Section: Discussionmentioning

confidence: 99%

Femur Shaft Fracture in Newborns: A Report of Two Cases

Vellingiri¹,

Venkataraman²,

Shanthappa³

et al. 2021

Cureus

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“…Whether these double diagnoses are due to coding errors, the identification of a cause, or delayed diagnosis cannot be ascertained, due to the study design with no access to patient records. In a clinical perspective, assessment of whether a fracture is birth-related or not has less importance for treatment; however, if the diagnosis is delayed and abuse is a potential cause, this can be of greater importance [ 8 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes

Heideken

Thiblin

Högberg

2020

BMC Musculoskelet Disord

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Background The purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents. Methods Children born in 1997–2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1–7 without registered trauma or abuse. Incidence was computed by comparing infants with femur or humerus shaft fractures to the total at-risk population. Results The incidence for birth-related femur shaft fractures was 0.024 per 1000 children (n = 45) and that for birth-related humerus shaft fractures was 0.101 per 1000 children (n = 188). The incidence was 0.154 per 1000 children for later femur shaft fractures (n = 287) and 0.073 per 1000 children for later humerus shaft fractures (n = 142). Birth-related femur shaft fracture was associated with shoulder dystocia, cesarean, multiple birth, breech, preterm, and small-for-gestational age, while humerus shaft fracture was associated with maternal obesity, dystocic labor, shoulder dystocia, vacuum-assisted delivery, male sex, multiple birth, breech, preterm, large-for-gestational age, birth weight > 4000 g, and injury of brachial plexus. A bone fragility diagnosis was recorded in 5% of those with birth-related or later femur shaft fractures. Among infants with birth-related humerus shaft fractures, 1% had a bone fragility diagnosis; the figure for later fractures was 6%. Maltreatment diagnosis was associated with later fractures of both types, especially among those aged < 6 months, where approximately 20% (femur) and 14% (humerus) of cases, respectively, were associated with abuse. Fall accidents were reported in 73 and 56% among those with later femur and humerus shaft fractures, respectively. Conclusion This study provides data on epidemiology, birth, parental characteristics, and reported accidents in relation to femur and humerus shaft fractures during infancy. Few children had a bone fragility diagnosis. Fall accidents were the main contributor to femur or humerus shaft fracture during infancy; however, the proportion of fractures attributed to maltreatment was high in children under 6 months.

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Delayed Birth-Related Femur Fracture after Cesarean Section: A Case Report

Cited by 10 publications

References 9 publications

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

Femur Shaft Fracture in Newborns: A Report of Two Cases

The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes

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