Birth-related femoral fracture in newborns: risk factors and management.

ABSTRACT

PURPOSE: 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. METHODS: 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. RESULTS: Mean gestational age was 37.2 weeks. Mean time to diagnose was 4 days. 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 4 weeks. No residual angulation or limb length discrepancy was noted after mean follow-up of 5 years. CONCLUSIONS: 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.