Suppr超能文献

健康新生儿的分娩相关长骨骨折与医疗职业责任:文献综述及病例报告

Birth-related long bone fractures in otherwise healthy newborns and medical professional liability: literature review and case presentation.

作者信息

Trabucco Aurilio M, Fava L, Chisari M, Bolcato M

机构信息

MESIT Foundation of Social Medicine and Innovation Tecnology, Rome, Italy.

Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), Rome, Italy.

出版信息

Front Med (Lausanne). 2025 Aug 11;12:1589417. doi: 10.3389/fmed.2025.1589417. eCollection 2025.

Abstract

Birth-related long bone fractures are rare but clinically significant events that require careful evaluation to distinguish them from fractures caused by underlying pathological conditions or non-accidental trauma. Their diagnosis and management have important clinical and medico-legal implications. A selective literature review was conducted to identify relevant studies published between 2004 and 2024, regarding incidence, mode of delivery, fracture location, time to diagnosis, treatment, and outcomes. Additionally, an original case report of a female neonate diagnosed with femoral shaft fracture on the third day of life. Neonatal long bone fractures can occur even in the absence of predisposing genetic or metabolic conditions. While they generally heal without for surgical intervention, timely diagnosis through appropriate imaging is crucial to ensure proper management. Failure to do so may expose healthcare professionals and institutions to potential medico-legal liability, both during delivery and in the immediate postnatal period. Preventive strategies should focus on careful prenatal risk assessment, adherence to best practices in delivery maneuvers, and early postnatal monitoring to optimize outcomes and minimize legal risks.

摘要

与出生相关的长骨骨折虽罕见,但具有临床意义,需要仔细评估以将其与由潜在病理状况或非意外创伤导致的骨折区分开来。其诊断和处理具有重要的临床和法医学意义。进行了一项选择性文献综述,以确定2004年至2024年间发表的有关发病率、分娩方式、骨折部位、诊断时间、治疗及结果的相关研究。此外,还报告了一例女性新生儿在出生第三天被诊断为股骨干骨折的原始病例。即使在没有易患遗传或代谢疾病的情况下,新生儿长骨骨折也可能发生。虽然它们通常无需手术干预即可愈合,但通过适当的影像学检查及时诊断对于确保正确处理至关重要。否则,在分娩期间及产后即刻,医疗保健专业人员和机构可能面临潜在的法医学责任。预防策略应侧重于仔细的产前风险评估、坚持分娩操作的最佳实践以及产后早期监测,以优化结果并将法律风险降至最低。

本文引用的文献

1
Ultrasound Diagnosis of Clavicle Fractures in Newborns: A Systematic Review.
Children (Basel). 2024 Sep 3;11(9):1080. doi: 10.3390/children11091080.
2
Mechanical Birth Injuries: A Comprehensive Five-Year Analysis From a Tertiary Care Hospital.
Cureus. 2024 Apr 25;16(4):e58997. doi: 10.7759/cureus.58997. eCollection 2024 Apr.
3
Transphyseal distal humeral separation in neonates: A case series.
Injury. 2023 Mar 16. doi: 10.1016/j.injury.2023.03.016.
4
Skeletal injuries after cesarean section - a rare differential diagnosis of child abuse.
Int J Legal Med. 2023 May;137(3):671-677. doi: 10.1007/s00414-023-02965-8. Epub 2023 Feb 13.
5
Ultrasound Instead of X-Ray to Diagnose Neonatal Fractures: A Feasibility Study Based on a Case Series.
Front Pediatr. 2022 May 26;10:847776. doi: 10.3389/fped.2022.847776. eCollection 2022.
6
Diaphyseal Fracture of the Humerus during Elective Cesarean Section - A Rare Case Report.
J Orthop Case Rep. 2021 Jun;11(6):10-13. doi: 10.13107/jocr.2021.v11.i06.2236.
7
The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes.
BMC Musculoskelet Disord. 2020 Dec 11;21(1):840. doi: 10.1186/s12891-020-03856-4.
8
Humeral Diaphysis Fracture in a Neonate After Vaginal Delivery.
Sisli Etfal Hastan Tip Bul. 2018 Mar 20;52(1):51-53. doi: 10.14744/SEMB.2016.25338. eCollection 2018.
9
Long bone fractures in neonatal intensive care units of Afyonkarahisar: Five-year's experience.
Turk J Obstet Gynecol. 2019 Dec;16(4):219-223. doi: 10.4274/tjod.galenos.2019.82346. Epub 2020 Feb 28.
10
Difficult birth is the main contributor to birth-related fracture and accidents to other neonatal fractures.
Acta Paediatr. 2020 Oct;109(10):2040-2048. doi: 10.1111/apa.15217. Epub 2020 Feb 29.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验