Farikou Ibrahima, Bernadette Ngo Nonga, Daniel Handy Eone, Aurélien Sosso Maurice
Department of Surgery and Surgical Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon.
J Orthop Case Rep. 2014 Jan-Mar;4(1):18-20. doi: 10.13107/jocr.2250-0685.141.
The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice.
The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa.
Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures.
剖宫产术的实施已知可减少长骨骨折的发生。我们在此呈现一例剖宫产术后新生儿罕见的股骨干骨折病例,这是我们14年临床实践中观察到的唯一病例。
该患者为一名孕38周出生的3.4千克女婴。母亲为初产妇,39岁。孕20周超声检查发现子宫内有肌瘤且为臀位。因此,建议行择期剖宫产。无明显可能导致股骨骨折的骨骼疾病。骨折通过双侧髋人字石膏成功治疗。剖宫产的指征为高龄初产妇、子宫肌瘤患者且为臀位。她总体健康状况良好,但由于在我们非洲的临床环境中未常规进行此项检查,其骨密度未知。
高龄、初产妇状态、子宫肌瘤的存在以及臀位是剖宫产的常见指征。然而,关于剖宫产术后股骨骨折的报道并不多。我们目前的病例表明,尽管分娩技术有了最新进展,但臀位剖宫产会使新生儿易发生股骨骨折。