Nadas S, Gudinchet F, Capasso P, Reinberg O
Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Skeletal Radiol. 1993;22(3):195-8. doi: 10.1007/BF00206153.
To compare various obstetrical methods with different types of obstetrical fractures, 29 neonates with fractures were evaluated retrospectively. Plain films of skull, limbs and chest were obtained. Transfontanellar ultrasonography was performed in one case and a computed tomographic scan of the skull in two. We reviewed 12 fractures of long bones, 7 fractures of the skull, and 10 fractures of the clavicle. Ten fractures occurred during caesarean sections and 11 in vaginal delivery requiring medical assistance. Depressed skull fractures were associated with manoeuvres and the use of forceps during delivery. Fractures of the long bones were associated with caesarean section, breech delivery with assistance and low birth weight. All fractures were treated conservatively except for skull fractures with depression of more than 2 cm. Early consolidation occurred in all fractures of long bones. The long-term follow-up of all fractures but one revealed no persisting disability. The belief that obstetrical fractures occur primarily in large babies or after breech delivery is not supported by this study.
为比较不同产科方法与不同类型产科骨折的关系，对29例骨折新生儿进行了回顾性评估。拍摄了头颅、四肢和胸部的平片。1例进行了经囟门超声检查，2例进行了头颅计算机断层扫描。我们回顾了12例长骨骨折、7例颅骨骨折和10例锁骨骨折。10例骨折发生在剖宫产期间，11例发生在需要医疗协助的阴道分娩过程中。凹陷性颅骨骨折与分娩时的操作及产钳使用有关。长骨骨折与剖宫产、臀位助产和低出生体重有关。除凹陷超过2 cm的颅骨骨折外，所有骨折均采用保守治疗。所有长骨骨折均早期愈合。除1例骨折外，所有骨折的长期随访均未发现持续残疾。本研究不支持产科骨折主要发生在巨大儿或臀位分娩后的观点。
