Fractures At First Breath: Functional Outcomes Of Neonatal Femoral Fractures Following Complicated Labour
Keywords:
Neonatal femur fracture, Complicated labour, Immobilisation, Compression bandage, Perinatal orthopaedic injuryAbstract
Background: Neonatal femur fractures are rare injuries, resulting from complicated labour including instrumental deliveries and breech presentation. These fractures are reason for parental anxiety and clinical concern. Early recognition and appropriate conservative management have a excellent outcome.
Objectives: To evaluate functional outcome, Radiological union, of neonatal femoral fracture sustained during complicated labour and managed conservatively.
Methods: This prospective observational study includes 10 neonates diagnosed with isolated femoral shaft fractures associated with complicated deliveries such as breech presentation, forceps or vacuum assisted delivery. All patient was treated conservatively using compression bandage. Clinical and radiological assessment were performed at presentation, 1, 3, 6 and 12-month post treatment. Functional outcome was assessed based on limb length discrepancy, range of motion, fracture union time and complications.
Results: The mean gestation age was 38 weeks, and the mean birth weight was 3kg, All the patient were treated with compression bandage. Radiological union was achieved in all patient within 3-4 weeks. At one year follow-up all the patient demonstrated excellent outcome. No cases of non-union, neurovascular compromise and limb length shortening was observed.
Conclusions: Neonatal femoral fractures related to complicated delivery can be effectively managed by conservative management resulting in excellent outcome. Early diagnosis, appropriate immobilisation and follow up are essential for optimal recovery.
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